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[How to organise cardiovascular management of cancer patients?]
Franck Thuny1, Jennifer Cautela1
1Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, unité Nord insuffisance cardiaque et valvulopathies, centre méditerranéen hospitalo-universitaire de cardiologie oncologique - Medi-CO Center, hôpital Nord, Marseille, France.
Insights
Cardio-oncology integrates cardiovascular care for cancer patients, assessing risks early and monitoring comprehensively to manage treatment-related heart issues effectively. This proactive approach improves patient outcomes.
Area of Science:
- Cardio-oncology
- Oncology
- Cardiovascular Medicine
Background:
- Cancer therapies improve survival but can cause cardiovascular adverse events.
- These events may limit treatment benefits and impact patient prognosis.
- Cardio-oncology addresses the need for integrated cardiovascular care in cancer patients.
Purpose of the Study:
- To outline an organized approach for cardiovascular management in cancer patients.
- To emphasize early risk assessment and comprehensive monitoring for cardiotoxicity.
- To improve patient outcomes through coordinated care.
Main Methods:
- Integrate cardiovascular risk assessment at cancer diagnosis.
- Implement closer cardiovascular monitoring for high-risk patients.
- Conduct comprehensive cardiovascular assessments beyond ejection fraction, including clinical exams, ECG, imaging, and biomarkers.
Main Results:
- Early identification of patients at risk for cardiovascular toxicity.
- Comprehensive cardiovascular monitoring to detect diverse toxicities.
- Facilitation of earlier, coordinated management of cardiovascular events.
Conclusions:
- Organized cardiovascular management is crucial for cancer patients undergoing treatment.
- Proactive and comprehensive cardio-oncology care improves overall prognosis.
- Integrating cardiovascular care into oncology ensures treatment effectiveness and patient safety.
Abstract:
How to organise cardiovascular management of cancer patients? Advances in cancer therapy have reduced cancer mortality. However, these results are sometimes achieved at the cost of cardiovascular adverse events that may limit the overall benefit of treatment. Cardio-oncology is a recent discipline that aims to prevent, screen and manage cardiovascular diseases associated with or secondary to cancer treatment without compromising its effectiveness. These goals must therefore be integrated into the patient care program at the time of cancer diagnosis. Therefore, a cardiovascular toxicity risk assessment should be conducted prior treatment to identify patients candidate for closer monitoring. In parallel with their oncologic follow-up, these high-risk patients should receive cardiovascular follow-up that should not be restricted to a solely measurement of the left ventricular ejection fraction. Indeed, toxicities can be multiple, so the assessment must be comprehensive and should include at least clinical examination, ECG, cardiac imaging, and sometimes biomarkers. In the case of cardiovascular events, this organisation will enable an earlier and coordinated management with oncologists, which will result in an improvement of the patients' overall prognosis.
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