The core components of cardio-oncology rehabilitation

Venturini, Elio; Gilchrist, Susan C.; Corsi, Elisabetta; Lorenzo, Anna Di; Cuomo, Gianluigi; D’Ambrosio, Giuseppe; Pacileo, Mario; D’Andrea, Antonello; Canale, Maria Laura; Iannuzzo, Gabriella; Sarullo, Filippo M; Vigorito, Carlo; Barni, Sandro; Giallauria, Francesco

doi:10.23736/s0031-0808.21.04303-2

Cited by 7 publications

(9 citation statements)

References 107 publications

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“…Clearly defined, evidence-based, effective, integrative multi-disciplinary models care exists within cardiovascular disease to assess, monitor and educate patients from diagnosis to long term follow up for a range of other cardiovascular diseases (24)(25)(26). Furthermore, while proven cardiooncology focused models exist, unfortunately these models are not yet widespread internationally (27)(28)(29). Additionally, the increasing adoption and prevalence of telehealth models of care represent a potential way to enhance access to timely specialised care for regional, rural and remote communities (30), who are a priori at the greatest risk of adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular outcomes of cancer patients in rural Australia

Williams

Kaur

Warner

et al. 2023

Front. Cardiovasc. Med.

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BackgroundCancer and heart disease are the two most common health conditions in the world, associated with high morbidity and mortality, with even worse outcomes in regional areas. Cardiovascular disease is the leading cause of death in cancer survivors. We aimed to evaluate the cardiovascular outcomes of patients receiving cancer treatment (CT) in a regional hospital.MethodsThis was an observational retrospective cohort study in a single rural hospital over a ten-year period (17th February 2010 to 19th March 2019). Outcomes of all patients receiving CT during this period were compared to those who were admitted to the hospital without a cancer diagnosis.Results268 patients received CT during the study period. High rates of cardiovascular risk factors: hypertension (52.2%), smoking (54.9%), and dyslipidaemia (38.4%) were observed in the CT group. Patients who had CT were more likely to be readmitted with ACS (5.9% vs. 2.8% p = 0.005) and AF (8.2% vs. 4.5% p = 0.006) when compared to the general admission cohort. There was a statistically significant difference observed for all cause cardiac readmission, with a higher rate observed in the CT group (17.1% vs. 13.2% p = 0.042). Patients undergoing CT had a higher rate of mortality (49.5% vs. 10.2%, p ≤ 0.001) and shorter time (days) from first admission to death (401.06 vs. 994.91, p ≤ 0.001) when compared to the general admission cohort, acknowledging this reduction in survival may be driven at least in part by the cancer itself.ConclusionThere is an increased incidence of adverse cardiovascular outcomes, including higher readmission rate, higher mortality rate and shorter survival in people undergoing cancer treatment in rural environments. Rural cancer patients demonstrated a high burden of cardiovascular risk factors.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular outcomes of cancer patients in rural Australia

Williams

Kaur

Warner

et al. 2023

Front. Cardiovasc. Med.

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“…Lymphoma survivors, especially those with anamnestic radiotherapy of the mediastinum that accelerates coronary atherosclerosis, also represent a group at increased risk. 7 Statins are the cornerstone of lipid-lowering therapies with fewer interactions with current CTs. Proprotein convertase subtilisin/kexin 9 inhibitors are a promising therapy, not only for their lipid-lowering effects but also for their potential to improve the anti-tumour functions of immune checkpoint inhibitors.…”

Section: Referral To Corementioning

confidence: 99%

“…Diabetes and metabolic syndrome can precede the diagnosis of neoplasia, as well as be favoured by the metabolic alterations induced by anticancer therapies such as antiandrogens, antiestrogens, and orchiectomies. 7 On the other hand, the complications of diabetes (peripheral arterial disease, neuropathy, and orthostatic hypotension) must be evaluated both as markers of CV damage and as influencers of the training programme.…”

Section: Referral To Corementioning

confidence: 99%

“… 5 , 6 Cardio-oncology rehabilitation must follow a customized pathway that takes into account patient’s CV risk at baseline, the scheduled oncologic treatment, and the end of treatment evaluation. 7 A vital issue is to identify patients who will benefit the most from a rehabilitation programme. This is of paramount importance to avoid the loss of patients after treatment ( from cancer patient to cancer survivor: lost in transition ).…”

Section: Introductionmentioning

confidence: 99%

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Cardio-oncology rehabilitation: are we ready?

Bisceglia,

Venturini,

Canale

et al. 2024

European Heart Journal Supplements

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Cardio-oncology rehabilitation (CORE) is not only an essential component of cancer rehabilitation but also a pillar of preventive cardio-oncology. Cardio-oncology rehabilitation is a comprehensive model based on a multitargeted approach and its efficacy has been widely documented; when compared with an ‘exercise only’ programme, comprehensive CORE demonstrates a better outcome. It involves nutritional counselling, psychological support, and cardiovascular (CV) risk assessment, and it is directed to a very demanding population with a heavy burden of CV diseases driven by physical inactivity, cancer therapy-induced metabolic derangements, and cancer therapy-related CV toxicities. Despite its usefulness, CORE is still underused in cancer patients and we are still at the dawning of remote models of rehabilitation (tele-rehabilitation). Not all CORE is created equally: a careful screening procedure to identify patients who will benefit the most from CORE and a multidisciplinary customized approach are mandatory to achieve a better outcome for cancer survivors throughout their cancer journey. The aim of this paper is to provide an updated review of CORE not only for cardiologists dealing with this peculiar population of patients but also for oncologists, primary care providers, patients, and caregivers. This multidisciplinary team should help cancer patients to maintain a healthy and active life before, during, and after cancer treatment, in order to improve quality of life and to fight health inequities.

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“…Figure 1 illustrates a proposal of the process for cancer patients and survivors who could significantly benefit from the established multidisciplinary CORE. Patients with chemotherapy, radiotherapy, or CVD risk factors are targeted populations (31). The process represents the recommended concept for cardiovascular risk assessment (medical history and symptoms) at the CORE baseline-this combination of cardiological and oncological assessment during treatment or in remission for cancer patients and survivors.…”

Section: Key Components Of the Corementioning

confidence: 99%

Cardio-Oncology Rehabilitation and Telehealth: Rationale for Future Integration in Supportive Care of Cancer Survivors

Baťalík

Filáková

Radkovcova

et al. 2022

Front. Cardiovasc. Med.

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The direct toxicity of cancer treatment threatens patients and survivors with an increased risk of cardiovascular disease or adverse functional changes with subsequent progression of cardiovascular complications. An accumulation of cardiovascular risk factors combined with an unhealthy lifestyle has recently become more common in cancer patients and survivors. It has been recommended to integrate a comprehensive cardiac rehabilitation model called cardio-oncology rehabilitation to mitigate cardiovascular risk. Nevertheless, cardiac rehabilitation interventions limit barriers in low utilization, further exacerbated by the restrictions associated with the COVID-19 pandemic. Therefore, it is essential to integrate alternative interventions such as telehealth, which can overcome several barriers. This literature review was designed as a framework for developing and evaluating telehealth interventions and mobile applications for comprehensive cardio-oncology rehabilitation. We identify knowledge gaps and propose strategies to facilitate the development and integration of cardio-oncology rehabilitation telehealth as an alternative approach to the standard of care for cancer patients and survivors. Despite the limited evidence, the pilot results from included studies support the feasibility and acceptability of telehealth and mobile technologies in cardio-oncology rehabilitation. This new area suggests that telehealth interventions are feasible and induce physiological and psychological benefits for cancer patients and survivors. There is an assumption that telehealth interventions and exercise may be an effective future alternative approach in supportive cancer care.

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The core components of cardio-oncology rehabilitation

Cited by 7 publications

References 107 publications

Cardiovascular outcomes of cancer patients in rural Australia

Cardiovascular outcomes of cancer patients in rural Australia

Cardio-oncology rehabilitation: are we ready?

Cardio-Oncology Rehabilitation and Telehealth: Rationale for Future Integration in Supportive Care of Cancer Survivors

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