Advances in newer anticancer treatments over recent years have contributed to increased survival among patients with cancer. As a result, cancer is now considered a chronic disease, similar to hypertension, dyslipidemia, diabetes mellitus and others, and requires systematic long-term monitoring. Increased survival, combined with the use of cardiotoxic treatments such as conventional chemotherapy, targeted therapy, immunotherapy and radiotherapy, can lead to cardiovascular complications including heart failure, acute coronary syndromes, arrhythmias and thromboembolic events, which may adversely affect patients’ prognosis and quality of life.

Cardiological assessment of oncology patients before the initiation of treatment, at regular intervals during therapy, and upon completion of treatment is considered essential. Cardio-oncology is a recently recognized subspecialty of Cardiology and mainly involves:

• Assessment of the risk of cardiotoxicity from anticancer treatment, early diagnosis, and supportive cardiological treatment.
• Management of oncology patients with pre-existing cardiovascular comorbidities, including heart failure, hypertension, hyperlipidemia, coronary artery disease, arrhythmias, valvular heart disease and others.
• Management of primary and metastatic tumors of the heart and pericardium.
• Participation of the cardio-oncologist in Oncology Multidisciplinary Team Meetings for the selection of the least toxic treatment regimen, combined with individualized cardiological monitoring and treatment (tailored treatment).

The main examinations performed in a cardio-oncology clinic include:

• Measurement of troponin and BNP through blood tests.
• Standard electrocardiogram (ECG).
• Echocardiography (cardiac ultrasound / Triplex).
• In selected cases, coronary CT angiography (CTCA).
• Clinical assessment of the above findings and collaboration with the oncologist or hematologist, as appropriate.

THEODOROS BISCHINIOTIS
M.D., PhD
Fellow of the European Society of Cardiology
Fellow of the International Cardio-Oncology Society
Former Coordinating Director
CARDIOLOGY-ONCOLOGY UNIT
Theagenio Cancer Hospital of Thessaloniki