Cardiovascular Health of Patients With Cancer and Cancer Survivors

Abstract

Many existing and emerging cancer therapies have significant impact on the cardiovascular (CV) health of patients with cancer and cancer survivors. This manuscript examines current aspects of interdisciplinary cardio-oncology clinical care delivery and education in the United States and outlines how these data provide a platform for future development of the field. We present the results of the nationwide survey on cardio-oncology services, practices and opinions, conducted among Chiefs of Cardiology and Program Directors, that demonstrate ranges of clinical activities and identify significant interest for increased educational opportunities and expert training of CV physicians in this field. The survey respondents recognized clinical relevance, but emphasized lack of national guidelines, lack of funds, and limited awareness and infrastructure as the main challenges for development and growth of cardio-oncology. We discuss potential solutions to unmet needs through interdisciplinary collaboration and the active roles of professional societies and other stakeholders.

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

“…Pacjenci z nowotworem i jawną klinicznie HF lub istotną dysfunkcją LV przed leczeniem onkologicznym wymagają specjalistycznej oceny kardiologicznej, najlepiej w wyspecjalizowanym ośrodku kardioonkologicznym, jeśli to możliwe, a stosunek korzyści do ryzyka w przypadku różnych możliwości chemioterapii powinien zostać przedyskutowany z zespołem onkologicznym [229][230][231][232]. Możliwości postępowania obejmują wybór alternatywnej niekardiotoksycznej chemioterapii, preparatów antracyklin charakteryzujących się mniejszą kardiotoksycznością (np.…”

Do current approaches to assessing therapy related adverse events align with the needs of long-term cancer patients and survivors?

“…The literature is extant with study of the unintended and delayed but potentially severe cardiac effects of anthracyclines (as used for decades to treat some childhood cancers, breast cancer, etc.) [1][2][3][4][5][6][7]. Unfortunately, even for novel therapeutic approaches such as checkpoint inhibiting immunotherapy, the community again finds itself facing unanticipated and uncertain cardiac adverse events (AE) associated with the primary therapy [8,9].…”

The emergence of a new specialty of oncocardiology

“…Projections from the SEER (Surveillance, Epidemiology, and End Results) database have shown a decreasing cancer incidence, with increasing survival now and in the coming years 1. With increasing survivorship, the prevalence of cardiotoxicities has also increased 2. Therefore, primary and oncology providers are encountering uncharted territory in the management of cancer therapy-related toxicities in their oncology patients and survivors 2.…”

“…With increasing survivorship, the prevalence of cardiotoxicities has also increased 2. Therefore, primary and oncology providers are encountering uncharted territory in the management of cancer therapy-related toxicities in their oncology patients and survivors 2. It is the need to manage these complications that has led to the development and growth of the field of oncocardiology 2 3.…”

“…Therefore, primary and oncology providers are encountering uncharted territory in the management of cancer therapy-related toxicities in their oncology patients and survivors 2. It is the need to manage these complications that has led to the development and growth of the field of oncocardiology 2 3. This editorial seeks to briefly summarise important aspects of oncocardiology and emphasise the necessity in growing this field.…”