Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Establishing multidisciplinary cardio-oncology clinics – a global perspective  (#56)

Susan Dent 1
  1. Duke Cancer Institute, Durham, NC, United States

Advances in cancer therapies have resulted in an increasing number of cancer survivors - in 2020 it is expected there will be over 18 million adult cancer survivors in the United States alone. Cancer treatments (eg chemotherapy, targeted therapy, immunotherapy, radiation therapy) can result in both short and long-term cardiovascular (CV) toxicities. Clinicians are tasked with providing optimal cancer care without compromising cardiovascular health. This is particularly challenging given the growing elderly population with pre-existing CV risk factors/disease. Cardio-Oncology has emerged as a new sub-specialty in medicine focused on the cardiovascular health of cancer patients and survivors.  Cardio-oncology clinics have emerged globally focused on the prevention, early detection, management and recovery of cardiovascular function resulting from cancer therapies.  International societies, such as the American Society of Clinical Oncology (ASCO), the American College of Cardiology (ACC), and the European Society of Cardiology (ESC) have endorsed cardio-oncology partnerships to enhance care delivery this patient population. 

So what have we learned?  Cancer and Cardiovascular disease often co-exist in the same patient: challenging providers with providing optimal care. Cancer and cardiac disease share a number of risk factors such as smoking, obesity, diet, inactivity. Cancer survivors are dying of cardiovascular disease! 

While our understanding of the cardiovascular consequences of cancer therapy has continued to evolve, many challenges remain. What are the mechanisms of cardiovascular toxicity, particularly with novel targeted therapies? How do we identify those cancer patients at greatest risk of cardiovascular toxicity? What are the best strategies to prevent cardiovascular toxicity? What are the best strategies for cardiovascular monitoring and surveillance during and following cancer therapy? How can we address the importance of lifestyle modifications, including diet and exercise? International collaboration, through organizations such as the International Cardio-Oncology Society (ICOS), are needed to address these important clinical questions.