With the increasing number of cancer survivors, the medical community is becoming increasingly aware of a hitherto less noticed health risk: cancer therapy-related cardiovascular disease. Meanwhile, cardiovascular disease triggered or exacerbated by cancer drugs ranks second among causes of long-term morbidity and mortality in cancer survivors. To mark World Heart Day on 29 September, Jutta Bergler-Klein from MedUni Vienna’s Division of Cardiology is raising awareness of the importance of preventing cardiovascular disease, particularly among cancer patients.
Cardio-oncology is the name given to the comparatively new field of research into the connections between cardiovascular diseases and cancer, the two most common causes of death in industrialised western countries such as Austria. As the prognosis for cancer patients improves, the phenomenon of cardiotoxicity is becoming increasingly significant. This is damage to patients’ hearts caused or exacerbated by chemotherapy and/or radiotherapy.
"We now know that cardiotoxicity can lead to high blood pressure, valve disease, premature coronary artery calcification, heart failure, coronary syndromes such as myocardial infarction or arrhythmia," clarifies Jutta Bergler-Klein from the Division of Cardiology within MedUni Vienna’s Department of Medicine II. In 2018, the cardiologist launched a special outpatient clinic for cardio-oncology at MedUni Vienna and is committed to drawing the attention of both doctors and patients to this specialty, which is gaining prominence in the medical world due to the growing number of cancer survivors.
Cardiac protection before, during and after cancer therapy
Cardio-oncology research shows that it is not only cancer drugs that can impair cardiac function but also substances produced by tumours. Conversely, chronic heart failure causes a chronic systemic inflammatory state, which can promote cancer development. Therefore, the prevention and management of cardiovascular disease are important at all times, especially after a cancer diagnosis and before, during, and after cancer therapy. Under no circumstances must the measures taken in any way delay or impede vital cancer treatment.
An international working group including Jutta Bergler-Klein recently drew up the first ever clear guidelines for cardiovascular primary and secondary prevention as well as treatment in cancer patients in the context of cardio-oncology guidelines. However, cancer patients themselves can also help to protect their cardiovascular system: "Cardiac risk factors, such as high blood pressure and high cholesterol levels, should be treated promptly. Exercise and sporting activity, even during chemotherapy, if possible, can reduce potential cardiotoxicity, for example by neutralising oxygen radicals and preventing muscle wastage," emphasises Bergler-Klein.
Publication: European Heart Journal
2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): Developed by the task force on cardio-oncology of the European Society of Cardiology (ESC)