Cancer and cardiovascular disease (CVD) are the two most common causes of death and disease worldwide! The incidence of both cancer and cardiovascular disease increases with age. With increased life expectancy, the burden of both diseases will increase substantially over the next decade.
Also, advancement in cancer therapy and supportive care has led to an increasing number of survivors of childhood cancer. Seventy percent of the children diagnosed with malignancy before the age of 15 years will have a disease-free 5-year survival from diagnosis. Cancer is now being recognized as a chronic disease, as evidenced by a growing number of cancer survivors that currently exceeds 11 million. With further improvement in cancer therapy, this number will likely increase in years to come. As the numbers of survivors grow so does the number of patients living with the late effects of cancer-related cardiotoxicity. Amongst Hodgkin lymphoma patients who have received radiation, CVD is one of the most common causes of death.
Physicians and ancillary staff frequently provide care for patients with cancer and cardiovascular disease. Some cardiac diseases predate the diagnosis of cancer, whereas other conditions like chemotherapy-induced cardiomyopathy and radiation-related heart disease are directly related to the cardiotoxic side effects of cancer therapy. The cardiotoxic side effects of 5-fluouracil, adriamycin, and tyrosine kinase inhibitors are well known. However, the cardiotoxic profiles of newer investigational chemotherapeutic agents are largely unknown.
Chemotherapy frequently induces thrombocytopenia, which in itself poses a therapeutic challenge in the management of conditions such as acute coronary syndrome, atrial fibrillation, stroke, and patients with prosthetic valves. Evidence-based treatment of cardiovascular disease in cancer patients is lacking largely because all cardiology trials have excluded patients with cancer and similarly cancer trials have excluded patients with significant cardiovascular comorbidity.
While recently some single-center studies have shown the efficacy of medications like ace inhibitors and beta blockers for the treatment of chemotherapy-induced cardiomyopathy, evidence-based treatments of other major cardiovascular diseases in cancer patients are not well established.
In our research, we have covered common conditions such as venous thrombosis, cardiovascular effects of radiation therapy, cardiovascular effects of anthracycline in childhood cancer survivors, and management of aortic aneurysm in cancer patients.
The use of a newer modality, such as computed tomographic angiography (CCTA), may provide a pivotal role in the investigation of cancer patients with concomitant cardiac problem, as outlined in a clinical investigation in the ICOS Journal. The case reports presented describe conditions that are unique to cancer population. Cardio-oncology is a growing field, and promotes collaboration between highly specialized professionals.
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Syed Wamique Yusuf (1), Carlo Cipolla (2), Jean-Bernard Durand (1), and Daniel J. Lenihan (3). Cardiology Research and Practice Volume 2011 (2011), Article ID 943748, 1 page doi:10.4061/2011/943748
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1451, Houston, TX 77030, USA
- Cardiology Unit, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
- Division of Cardivascular Medicine, Vanderbilt University, 1215 21th Avenue South, Nashville, TN 37232, USA
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