Cancer and cardiovascular health: a multidisciplinary approach

Early detection and improved cancer therapies have led to increases in cancer survivorship. There were 18.1 million cancer survivors in the United States alone in 2022, and this number will grow to 21.6 million by 2030. Cancer survivors are at increased risk for non-cancer-related morbidity and mortality, including cardiovascular disease. Cardio-oncology has emerged as a new subspecialty of medicine, dedicated to improving the cardiovascular health of patients with cancer and facilitating the administration of the best cancer therapy while optimizing cardiovascular health. Contemporary cancer treatments are associated with multiple types of cancer treatment-related cardiac dysfunction (CTRCD), including heart failure, vascular toxicities, arrhythmias/corrected QT prolongation, hypertension, and myocarditis. In 2022, the European Society of Cardiology published comprehensive guidelines that endorsed the Heart Failure Association/International Cardio-Oncology Society baseline risk stratification tool for assessing all patients with cancer before cancer therapy is started. Primary prevention strategies can be considered for patients at high risk and very high risk for CTRCD, with the goal of facilitating the delivery of cancer therapy while minimizing the risk of cardiovascular toxicity. Dedicated multidisciplinary cardio-oncology clinics have emerged across North America, Europe, South America, Asia, South Africa, and Australia to enhance cancer care while optimizing cardiovascular health.