Battling cancer can have long-term effects on the heart.

Treating cancer isn’t yet a precise science. Although doctors are getting better at targeting tumors, there’s still no magic bullet that homes in on cancer cells and destroys them without risking collateral damage to other parts of the body. The outward signs of off-target destruction include classic side effects of chemotherapy and radiotherapy such as hair loss, nausea, and fatigue. But there can be silent inner damage, too, sometimes to the heart and arteries. These injuries can appear immediately during therapy; other times they don’t surface for years.

“Important advances in our ability to fight cancer over the last few decades have translated into improved survival,” says Dr. Erica L. Mayer, an oncologist at Harvard-affiliated Dana-Farber Cancer Institute. “But we are also learning that many of these lifesaving therapies have the potential to affect the heart and other parts of the body.”

Once relegated to the back burner, the late effects of cancer care are gradually getting more attention. One turning point was the publication in 2005 of From Cancer Patient to Cancer Survivor: Lost in Transition. This influential report from the Institute of Medicine put a spotlight on the disjointed care often received by the 12 million-plus cancer survivors in the United States after their cancer treatment has ended.