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I'm here about breast cancer. Why are you talking to me about my heart? # 39;



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Many doctors do not tell cancer patients about the dangers of cardiotoxicity treatments and may not be fully aware of the risks themselves. A new study shows that these patients need to be looked after urgently. Today's research is presented at EuroHeartCare 2019, the European Association of Cardiology (ESC) scientific congress.

"There was no mention that it could lead to heart disease. Would it have been nice to know."

The increasing number of cancer survivors and an increasing number of people over 65 requiring chronic cancer therapy means that the need for cardio-oncology services is increasing. Heart failure caused by cancer therapy can occur up to 20 years after the procedure. In 2012 over 32 million people worldwide lived with cancer.

"Depending on the type of chemotherapy and radiotherapy, between 1% and 25% of cancer patients can develop heart failure because of cancer treatment," said study author Professor Robyn Clark, of Flinders University, Adelaide, Australia. "Risk also depends on cardiovascular risk factors such as smoking and obesity. Monitoring of the heart and intervention can be preferable before, during and after treatment prevent or reduce the impact of this cardiovascularity."

The researchers reviewed the medical records of 46 randomly selected cancer patients with cardioxidation who attended one of three hospitals between 1979 and 2015. Only 11% were referred to a cardiologist before chemotherapy and less than half (48%) were referred to a heart failure clinic. after cancer treatment. Almost 40% were overweight or obese, 41% were currently smokers or ex-smokers, 24% were regular alcohol users, 48% had hypertension, and 26 had overweight. % diabetes.

In a subset of patients, a pre- (1994-2011) exercise was followed and after (2012-2015) published the European Association for Medical Oncology guidelines 2012. The referral to a cardiologist before chemotherapy increased from 0 to 23% and increased. maintain the heart core echocardiogram from 57% to 77%.

Eleven patients were interviewed, seven of whom were involved in medical records analysis. No patient could express their heart health needs. More than half said they had started eating healthily after their cancer diagnosis but again they did not seem to have an understanding of a balanced diet.

The ESC published recommendations in 2016 and in 2018 launched the ESCO Cardio-Oncology Council to promote prevention, early diagnosis and management of cardiovascular disease associated with cancer therapy. Patients should be told about the risks to their heart before starting cancer therapy, helping them to give up smoking, eating healthily, exercising, and managing their weight, and finding out about signs. and the symptoms of cardiovascular disease.

Cardiotoxicity is detected using an electrocardiogram (ECG), cardiac imaging, and biomarkers. The frequency of assessment depends on a number of factors – for example, evaluation for coronary artery disease, ischaemia and vascular disease in patients with a history of mediated radiation starting after treatment after five years and then at least every five years is recommended. thereafter, even if they have no symptoms.

Angiotensin (ACE) conversion enzymes or beta-blockers can be given to prevent or treat heart failure. And cancer therapy can be adjusted – for example, reducing the dose or having a gap between two agents that raise the risk of heart failure when taken with each other (eg anthracyclines and trastuzumab).

"Monitoring the heart throughout the cancer journey can ensure that it is protected," said Professor Clark. "Cardiotoxicity can occur even in people without cardiovascular risk factors because drugs such as anthracyclines and trastuzumab are toxic to the heart, so there is an innocent viewer."

"For cancer patients developing heart failure, there are clinics that will improve their quality of life but our study shows that many are not being referred," he added. "Telephone calls to support and monitor those with cancer and heart failure would reduce the burden of hospital appointments, and patients said that that was our priority."


New study targets 'double cancer'; breast cancer


More information:
The summary is presented 'Establish a practice gap to guide the implementation of more effective cardio-oncology clinical services: a retrospective audit examining the clinical management of patients with cardiothraxy & # 39; during a moderate poster session – Heart Failure on Saturday 4 May at 10:45 am to 11:45 pm CEST in the Poster Area has been moderated.

Provided by
European Cardiology Society

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I'm here about breast cancer. Why are you talking to me about my heart? # 39; (2019, May 4)
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