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Specialist clinics
10 MARCH 2019 • HEALTHCARE INNOVATIONS
Heart health in cancer patients and survivors — the rise of cardio-oncology
Te emergence of cardiovascular diseases in cancer patients and survivors has led to the development of a new field of modern medicine known as cardio-oncology
In 2011, Dr Alexander Lyon and his colleagues at the Royal Brompton Hospital in London set up the coun- try’s first dedicated specialist cardio-oncology service.
THE CARDIO-ONCOLOGY SERVICE Te mission of
the cardio-oncology
service is to improve the cardiovas- cular health of people before, during and after cancer treatment. Tis allows cancer patients to benefit from modern cancer treatment safely from a heart perspective and, after treat- ment, reduce the risk of developing future heart problems. Dr Lyon explains: “In simple terms, we’re trying to prevent
the cancer
patient of today becoming the cardiac patient of tomorrow. In the UK and internationally, we’ve seen a signifi- cant increase in the number of cancer patients with cardiovascular prob- lems, particularly related to pre-ex- isting heart problems becoming dest- abilised by their cancer treatment. “We also look after many patients
with specific cardiac complica- tions arising from the cancer treat- ments
themselves. Tis relates to
some chemotherapies and many of the modern ‘designer’ cancer treat- ments targeting specific molecular pathways within the cancer, that have proven very effective.”
WHO’S AT RISK? “It’s not known when an indi- vidual may have a heart attack due to blockage of a coronary artery. However, it is known exactly when they’ll receive a chemotherapy infu- sion or radiotherapy, when their heart is in the radiation field during radio- therapy or when they’ll have a tablet prescription for a cancer treatment. Tis allows us an opportunity to implement a strategy with baseline risk assessment, and identifying those people at highest risk, before they start their cancer treatment. “Te goal isn’t to block cancer treat-
ment, but to support it by closely monitoring cardiac function to pick up the earliest changes. We provide a personalised plan either to initiate heart protection medicine in people at the highest risk before they start their cancer treatment, or close monitoring of their heart health and treatment
DR LYON AND RACHEL WELLBELOVE
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