Whether you’re a patient with cancer or a cancer survivor, heart health ought to be top of mind. People may not realize just how intertwined these conditions can be.

“There’s a huge overlap between cancer and cardiovascular disease,” explains Michelle Bloom, MD, director of the Cardio-Oncology Program at NYU Langone Health. “We think there are a lot of shared risk factors, like high blood pressure, high cholesterol, and diabetes.”

And while chemotherapy and radiation therapy are a vital part of many cancer care plans, these treatments can increase heart disease risk—even decades into survivorship, she points out.

Awareness that cancer and heart health are connected puts you in a position to be proactive. Dr. Bloom offers these five strategies to keep your heart and blood vessels healthy.

1. Get Personalized Nutritional Counseling

A nutritious diet can help keep cholesterol in check, reduce blood pressure, prevent high blood glucose (or sugar), and protect against damage to blood vessels. Eating nutritious foods can also help you maintain a healthy weight during cancer treatment and cope with the side effects of cancer treatment.

Dr. Bloom encourages her patients to eat the following:

• plant-based proteins, such as beans, nuts, and other legumes
• whole grains, like oats, quinoa, and brown rice
• healthy fats, like olive oil and avocado
• a variety of fruits, including berries and vegetables

People who have cancer may need to adjust their diets as they go through treatment, says Dr. Bloom, who is also a professor in the Department of Medicine at NYU Grossman School of Medicine and NYU Grossman Long Island School of Medicine and site director of the Cardio-Oncology Program at NYU Langone Hospital—Long Island.

Some cancer treatments cause poor appetite, nausea, mouth sores, or other side effects. A nutritionist can create an eating plan that considers these side effects and other potential limitations, while reducing cardiovascular risk. Nutrition services are available at NYU Langone’s Perlmutter Cancer Center.

2. Listen to Your Body and Ease into Exercise

Physical activity is great for heart health because it can help maintain your weight and reduce blood pressure and cholesterol. And for cancer survivors, there’s an added benefit. Those who exercise have a lower risk of cancer coming back and improved rates of overall survival than those who don’t exercise.

But if you’re fatigued and nauseated due to the side effects of cancer treatment, exercising can be difficult. “You may not be able to get out of bed some days,” said Dr. Bloom. She encourages people to exercise to the best of their ability. “Listen to your body. If it’s a day that you can’t be active, give yourself a break.” If you feel better the next day, try walking for 5 to 10 minutes, then increase this amount over time.

If you need help building up your strength and endurance, providers at Rusk Rehabilitation offer cancer rehabilitation services such as physical therapy and occupational therapy.

3. Consider Prescription Medication

In addition to lifestyle changes, medication may help to protect your heart health during and after cancer treatment.

High blood pressure and high cholesterol can be managed with medications, and so can conditions, such as heart failure, that might develop after cancer treatment. If you have prediabetes or diabetes that isn’t being adequately controlled, you may be referred to an NYU Langone endocrinologist, who might recommend prescription drugs.

A cardio-oncologist can make any needed adjustments in your medications to balance your cancer treatment and cardiovascular needs, explains Dr. Bloom.

4. Get Recommended Screenings

Ongoing cardiovascular screening is another crucial part of care, but it does not have a one-size-fits-all approach, says Dr. Bloom. Cardio-oncologists follow screening guidelines for certain groups of patients who are receiving specific cancer treatments.

As an example, women who received the class of chemotherapy drugs called anthracyclines for breast cancer have a higher risk of developing heart disease because they can be toxic to the heart. They will typically have an echocardiogram, a test that uses ultrasound to create images of the heart, before starting chemotherapy to make sure the pumping function of the heart is good and the valves are healthy.

These patients should have at least one echocardiogram after chemotherapy. Beyond this, monitoring is personalized. “Because I’m also a heart failure cardiologist, especially in patients considered to be higher risk, I screen on an ongoing basis because I see these women develop heart failure years later, and early detection is the key to better outcomes,” says Dr. Bloom.

5. Forgo Tobacco

Smoking is a risk factor for both cardiovascular disease and cancer. NYU Langone offers several Tobacco Cessation Programs that are readily accessible to patients.

“I want patients to know that even if you’ve smoked for decades, the day that you quit is the day that you improve your health,” says Dr. Bloom. “It’s never too late.”