Cardio-Oncology at CHRISTUS Health

What is Cardio-Oncology?

Cardio-oncology care focuses on safeguarding your heart during cancer treatment.

Different specialists work together to protect your heart from cancer therapy's potential damage or side effects.

By proactively addressing potential damage or side effects, especially from advanced therapies like immunotherapies, cardio-oncology aims to ensure your cardiovascular well-being throughout your cancer journey.

What is the Difference Between a Cardio-Oncologist and a General Cardiologist?

A general cardiologist focuses on preventing, diagnosing, and treating many cardiac diseases. Most general cardiologists are unfamiliar with new cancer therapies that may interfere with cardiovascular health and medicines.

A cardio-oncologist is specifically trained to recognize and manage cardiac complications due to cancer treatments. 

They actively collaborate with oncologists to monitor patients’ heart health during and after cancer treatment so that therapies can be adjusted if needed. They accomplish this through their expertise in potential interactions of cancer therapy with heart health and medications.

How Cardio-Oncology Helps Cancer Patients

Some cancer treatments can cause side effects in a patient with cancer that can increase the risk of heart disease in the future, even after cancer therapy is finished.

This includes:

  • Heart failure or weakness of the heart muscle
  • Coronary artery disease, or blocked arteries of the heart
  • Arrhythmias or heart rhythm problems, like atrial fibrillation
  • Hypertension, or high blood pressure
  • Heart valve disease
  • Edema, or fluid retention

Cardio-oncologists are trained to manage these cardiac conditions during cancer treatment while also caring for these patients’ pre-existing cardiac conditions. This is in close collaboration with your oncologist.

Cardio-oncologists also screen cancer survivors for potential heart diseases that can develop years after cancer therapy.

They guide their therapy by offering advice for mitigating certain risk factors and guiding patients on what therapy will most effectively preserve or restore their cardiovascular health long-term.

High-risk patients with preexisting heart illnesses, including heart failure, coronary artery disease, heart arrhythmias, and other cardiovascular conditions, are closely monitored and treated by a cardio-oncologist familiar with their cancer treatment and its potential side effects.

Treatment includes adjustment of blood thinners, fluid pills, heart failure medications, cholesterol medications, and blood pressure medicines.

Questions About Cardio-Oncology

When Should I Seek Care from a Cardio-Oncologist? 

Getting Help Before Cancer Treatment Starts

New international guidelines recently detailed the characteristics of a patient who may benefit from a cardio-oncology program. Doctors use different methods to grade patients as low, moderate, high, or very high risk of developing cardiovascular complications.

The ideal time to start taking steps to prevent this kind of harm is before cancer treatment begins. It's important to remember that different cancers and treatments can impact the heart differently, so care needs to be personalized based on the individual's situation.

What if I Already Have a Cardiologist? 

Even though many patients with heart conditions are established with a regular cardiologist, cardio-oncologists can see you while you get cancer treatment and then return to your general cardiologist once cancer treatment is completed.

This ensures that you receive the safest and most effective treatment for your cancer with the least potential unwanted effects on your heart.

Once treatment is finished, the cardio-oncologist will update your general cardiologist about your treatment and results.

Who May Need a Cardio-Oncology Program? 

Patients Who Have a History of Congestive Heart Failure

These patients have a history of congestive heart failure, coronary artery disease, heart arrhythmias, or other cardiovascular diseases. They are at a higher risk of developing cardiovascular issues in the future, especially when undergoing cancer treatment. Cardio-oncology can help manage these patients' heart health and reduce their risk of developing complications during treatment.

Patients with Pre-existing Cardiovascular Conditions

Cancer treatments such as chemotherapy and radiation therapy can have damaging side effects on the heart and vascular system. Patients at risk for these side effects, such as those with pre-existing cardiovascular conditions, may benefit from cardio-oncology care. By monitoring these patients closely and providing appropriate interventions, cardio-oncologists can help reduce the risk of long-term heart damage caused by cancer treatment.

Patients on Long-Term Immunotherapy Drugs

Immunotherapy drugs have become an increasingly important part of cancer treatment. However, they can also cause cardiovascular complications such as heart attacks, hypertension, and heart failure. Patients on long-term immunotherapy drugs are at a higher risk of developing these issues. Cardio-oncologists can work with oncologists to monitor these patients and provide interventions to reduce their cardiovascular risk.

 

What is Cardiotoxicity? 

Cardiotoxicity is a side effect in cancer patients due to the use of some chemotherapy and radiation therapy drugs.

Cardiotoxicity causes heart muscle inflammation and an abnormal increase in troponin levels. These drugs can damage the heart muscle and lead to several symptoms:

  • Chest pain
  • Shortness of breath
  • Irregular heartbeat
  • Fatigue

The risk of developing cardiotoxicity depends on different factors:

  • The type and dose of the drugs
  • Pre-existing heart conditions
  • Age
  • High blood pressure
  • Lifestyle habits, such as smoking.

Cardiotoxicity can affect cancer patients’ long-term quality of life.

 

About Our Cardio-Oncology Program

The Cardio-Oncology program began as a close collaboration of the Northeast Texas Cancer & Research Institute. This program seeks to address the needs of cancer patients with complex cardiovascular diagnoses. The Cardio-oncology team evaluates cancer patients before, during, and after therapy to reduce potential unwanted side effects of cancer treatment. With a team of cardio-oncologists, oncologists, surgical oncologists, and gynecologic oncologists, we strive to provide patients with the most effective cancer therapy while minimizing damage to their cardiovascular system.

About CHRISTUS Health Cardio-Oncology Care

Our team is committed to providing patients with compassion, care, and respect as we strive to provide the best possible care. We understand cancer treatment is difficult, and we are dedicated to helping our patients find the best path toward a healthier future.

Our commitment to patient-centered care starts by understanding our patients' unique needs and combining our specialists' expertise in cardiovascular disease and cancer treatment.

If you or a loved one needs cardio-oncology care, don't hesitate to get in touch with us to explore your treatment options. We are here for you and are committed to helping you find the best path toward a healthier future.

 


 

Dr. Peter Pitonak, medical director of cardio-oncology for CHRISTUS Health in Tyler, contributed to this article.

Additional facts were verified from research in the European Heart Journal.