Caring for the hearts of cancer patients
Understanding Cardio-oncology
What is it?
Patients with cancer may have a higher risk of developing cardiovascular disease, as cancer therapies may affect the heart and vascular systems. It is important to prevent, monitor and treat cardiovascular disease in cancer survivors and patients to ensure long-term health. Our team of leading cardiologists and oncologists collaborate to provide comprehensive cardiovascular care to patients with cancer who have, or are at risk for, heart disease.
We seek to evaluate patients so that cancer therapy can be aggressive and curative, and to ensure that cardiac disease is not the result of that aggressive therapy.
Our program goals are as follows:
- Ensure better outcomes for patients with heart disease and cancer
- Recognize early cardio toxicity from therapies
- Prevent, reduce, and if possible, reverse cardiac damage
- Monitor patients with potential cardiac issues undergoing chemo or radiation therapy
- Understand cardiac issues during cancer therapy by research collaboration
- Remove cardiac disease as a barrier to effective cancer therapy
- Participate in establishing best survival practices for cardiac surveillance after therapy
Who is it for?
The focus is on 3 groups of individuals, and within these groups, we try to follow the highest risk individuals:
- Those with existing heart disease who develop cancer, to insure their heart can withstand the stress of treatment. All these patients (men or women) need to see their cardiologist or be referred.
- Those who are considered cancer survivors and have either undergone radiation therapy with portals that have included the heart, or received cardio toxic regimens, need to be followed by cardiology periodically, as part of their disease surveillance program.
- Those currently undergoing chemotherapy with cardio toxic agents to monitor for subtle changes in cardiac function that may signal an early decrease in cardiac function. This is important, as there are evolving data to suggest that early treatment may reduce damage or prevent further damage.
What risk assessments & treatments are offered?
We provide the following services:
- Risk Assessment Prior to Cancer Treatment
Before undergoing medical or surgical treatments for cancer, it is important to understand your risk for developing cardiovascular disease. We work closely with your oncologist and provide a comprehensive evaluation prior to cancer therapy to minimize any potential cardiovascular complications from cancer treatment. We combine a complete, personalized assessment with appropriate diagnostic testing and optimal cardiovascular therapies to help ensure your best outcome.
- Care for Cancer Patients with Existing Cardiovascular Disease
Management of conditions such as hypertension, coronary artery disease, congestive heart failure, heart valve disease and arrhythmias (abnormal heart rhythms) in cancer patients requires an approach customized to their overall care. Our goal is to treat existing cardiac conditions so that you are healthy enough to respond well to your cancer treatment.
- Monitoring for Cardiac Complications from Cancer Therapy
If you are actively receiving chemotherapy or have previously completed chemotherapy and/or radiation therapy, you may experience symptoms related to hypertension, coronary artery disease, congestive heart failure, valvular heart disease, pericardial disease and arrhythmias. With early recognition and treatment, many complications of chemotherapy and/or radiation therapy can be managed successfully.
- Assessment of Long-term Cardiac Risk in Cancer Survivors
There is increasing evidence that shows that survivors of cancer face higher risks of cardiovascular disease. We provide a comprehensive risk assessment that includes a detailed history, physical examination, lab work and diagnostic testing. Strategies to reduce cardiac risk include dietary and lifestyle modifications and, when appropriate, medical therapy.
- Assessment of New Chemotherapies
Many of the new chemotherapeutic agents in clinical and pre-clinical studies have the potential to damage the heart (cardiotoxicity). We administer advanced diagnostic tests to identify cardiotoxicities for patients undergoing treatment with new chemotherapies. These may include diagnostic imaging, noninvasive stress testing, serum biomarkers (blood tests which can indicate heart dysfunction), ambulatory blood pressure monitoring and ambulatory cardiac telemetry (continuous monitoring of a patient’s heart from a remote location) can help identify cardiotoxicities and lead to the development of preventative strategies.
- Evaluation of Cardiac Tumors
Use imaging technology to evaluate cardiac (heart) tumors, which are abnormal growths in the heart or heart valves. The imaging technology includes:
- Echocardiography (with 3-D imaging), which provides an ultrasound of the heart
- Cardiac computed tomography (CT), which uses an X-ray machine that moves around the body to take images of each part of the heart
- Cardiac MRI, a type of MRI that creates images of the heart and major blood vessels
- Positron emission tomography (PET), which provides a 3-D image of functional processes in the body
Why is this program needed?
Cancer is a devastating disease and represents a common health problem our nation faces. intimately related to heart disease.
Studies have shown that 30% of all cancer patients will develop some cardiovascular complications due to their treatment?
Many of the chemo agents, such as anthracyclines, can cause some form of cardiac damage, which can be directly toxic to the heart muscle, or cause hypertension, glucose intolerance, or excessive fluid retention that can weaken the heart.
Radiation of the chest can affect the heart and cause heart failure, arrhythmia, valve disease and even heart attacks.
These effects can manifest early during treatment, or years later when everyone has assumed that the patient is clear of cancer problems. We have, at that time, substituted one disease for another, which is just as devastating.