Cardio-oncology focuses on heart complications in cancer patients
Hearing the news that you have cancer can be devastating enough, but to also learn that the medications and therapies that could fight the cancer could also damage your heart likely takes most patients by surprise.
Chemotherapy and newer immunotherapies, along with radiation and hormone-based therapies, all can contribute to cardiotoxicity or heart damage.
“A patient’s risk of developing cardiotoxicity varies, mainly depending on his or her specific treatment, the patient’s underlying health condition and if he or she is predisposed to cardiovascular disease, among other factors,” says Dr. Valentyna Ivanova, board-certified cardio-oncologist at the AHN Cardiovascular Institute and cardiology medical director of the AGH Cardio-Oncology Center. Cardio-oncology is a specialized field of medicine that focuses on the prevention, diagnosis, and treatment of cardiovascular complications in cancer patients and cancer survivors. “It recognizes the significant link between cancer treatments and heart problems, which is referred to as cardiotoxicity, a heart condition caused by cancer treatments like radiation, chemo, immune- and hormone-based therapies,” Ivanova says.
Pittsburgh’s Allegheny General Hospital was recently recognized as an esteemed Gold-Level Center of Excellence by the International Cardio-Oncology Society, joining just 14 other gold-level institutions across six countries in this year’s class. That designation is awarded to institutions that demonstrate the highest standard of care in the treatment and management of patients who are at risk of cardiotoxicity. The AGH team takes a multidisciplinary approach with a team composed of both cardiac and cancer specialists who can screen, closely monitor, manage and treat patients with existing heart disease prior to cancer treatment or who are at risk of developing it during or after treatment. That treatment can include care plans for cardiovascular complications like hypertension (high blood pressure), arrhythmia, or a decline in heart function. They also focus on nutrition, exercise and general lifestyle counseling to minimize cardiovascular impact as well as medication management and ongoing imaging and monitoring of the cardiovascular system.
“Our heart specialists coordinate care with experts from the AHN Cancer Institute to minimize cancer treatment’s impact on the heart, tailor treatment plans for cardiotoxicity, evaluate cardiovascular risk profiles for new cancer therapies, and closely monitor patients who may be predisposed for heart complications due to cancer treatments,” says Ivanova. “It’s an approach to care that treats each patient holistically, ensuring their treatment plans are carried out to achieve the best possible long-term health outcomes.”
Cardio-oncology is a relatively new field of emerging medicine that has gained traction in recent years. Its emergence as a field of treatment is due in part to more success in fighting cancer and the unsettling realization that some of those cancer treatments can also harm the heart. “The increasing survival rates of cancer patients, due in part to improved treatments, mean more individuals are living long enough to experience long-term cardiovascular side effects of cancer therapies which requires a highly specialized skill set and level of expertise to treat and/or manage,” explains Ivanova. “The use of newer, more effective (but sometimes more cardiotoxic) therapies like certain chemotherapies and immunotherapies has spurred a need for an increased focus on how cancer treatments can impact patient heart health.”
A cardio-oncologist’s goal is to reduce the side effects of cancer treatment on the cardiovascular system and help patients get the most effective cancer treatment with the least amount of heart damage. How cancer treatment will affect the heart can be a difficult conversation but one that cancer patients need to have with their oncologists.
“The best advice for cancer patients is to discuss their cardiovascular risk with their oncologist and a cardiologist, ideally one specializing in cardio-oncology,” she adds. “A multidisciplinary approach is crucial. There isn’t a good choice in terms of treatment that guarantees no cardiovascular side effects, but physicians will work with patients to determine the best approach depending on the cancer’s type, severity, and the patient’s overall threshold for cardiovascular complications. Open communication and careful monitoring are key, and preventive measures and early detection of cardiovascular issues can significantly improve long-term outcomes.”