Heart Center Cardio-Oncology

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Heart Center Cardio-Oncology

Cardio-Oncology Program

Over the last several decades, cancer treatments have advanced significantly. Despite these advances, life-saving cancer treatments can still cause unwanted side effects to other organs, including the heart. The medications’ harsh effects can cause cardiac (heart) issues during treatment or the effects can appear many years after treatment has finished. 

Health experts refer to these resulting conditions as cancer-treatment-related cardiotoxicity (CTC) — damage to the heart and vascular system.

Due to the risk of CTC, it is important to have a cardiac specialist involved in the care of cancer patients — both those undergoing treatment and cancer survivors. 

Children’s Mercy Hospital Specializes in Cardio-Oncology 

Fortunately, medical experts such as those at Children’s Mercy Hospital have recognized the growing prevalence of this problem. As a result, we are one of only a few pediatric hospitals in the world to offer cardio-oncology. Our program offers specialized treatment for cancer patients that incorporates cardiovascular screenings by our pediatric cardiologists both during our cancer-treatment programs as well as afterward in our survivorship program. 

Why Is Cardio-Oncology Important?

Research shows that the most common cancer treatments can result in damage to the heart or vascular system. These heart problems include:

  • Heart failure (when the heart can't pump enough blood to meet the body’s needs)
  • Myocardial infarction (commonly known as a heart attack, when blood flow stops to a part of the heart causing damage to the heart muscle, potentially leading to heart failure, an irregular heartbeat or cardiac arrest)
  • Valvular heart disease (when one or more of the heart valves don't work well)
  • Pericarditis (a condition in which the membrane, or sac, around the heart is inflamed)
  • Left ventricular dysfunction/cardiomyopathy (where the heart muscle becomes enlarged, thick or rigid and can’t contract and relax normally)
  • Dyslipidemia (high cholesterol)
  • Hypertension (high blood pressure)
  • Vascular disease (an abnormal condition of blood vessels)
  • Arrhythmia (a problem with the heartbeat’s rate or rhythm)
  • Obesity (excess body fat)

Addressing potential cardiac concerns from the start of cancer therapy can help manage these possibilities, especially for patients with pre-existing cardiovascular conditions. 

What Types Of Cancer Treatments Cause Heart Problems?

Research shows that some cancer treatments can lead to heart damage. One of the most common is chemotherapy using anthracyclines, a type of antibiotic that comes from certain types of Streptomyces bacteria. Anthracyclines damage the DNA in cancer cells, causing them to die. 

The most often prescribed anthracyclines are:

  • Doxorubicin (Adriamycin®)
  • Daunorubicin/daunomycin (Cerubidine®)
  • Idarubicin (Idamycine®)
  • Mitoxantrone (Novantrone®) 
  • Epirubicin

Other cancer therapies can also increase the chances of developing cardiovascular disease, such as:

  • Radiation therapy
  • Other chemotherapy drugs

What Hospitals Offer Cardio-Oncology Treatment?

Although most hospitals involve cardiology (heart specialists) as consultants when cancer patients have pre-existing cardiac issues, Children’s Mercy has a different approach. We have created a unique and special collaborative clinic to best coordinate the complex needs of children facing cancer. 

How Children’s Mercy’s Cardio-Oncology Program Works

When your child is first evaluated, a pediatric cardiologist works alongside your child’s oncologist (cancer doctor) and other medical professionals to evaluate and manage your child’s heart health from the initial cancer diagnosis through the treatment regimen and into remission. Your child’s health-care management includes:

  • Identifying cancer-related heart disease in its early stages
  • Minimizing cardiotoxic side-effects
  • Tracking disease using imaging techniques (such as CT scans or MRIs) or serum biomarkers (proteins in blood, urine or other body fluids that indicate the presence of cancer)
  • Initiating additional therapy as needed

Ultimately, the team’s collaborative efforts can improve the quality of care for your child. 

What Does Long-Term Cardio-Oncology Treatment Include?

Children’s Mercy’s Cardio-Oncology Program ensures that any child treated for cancer with chemotherapy or radiation will receive follow-up care that includes:

  • A baseline electrocardiogram (EKG) at the beginning of long-term follow-up (about two years after final treatment)
  • An echocardiogram at the beginning of long-term follow-up
  • An echocardiogram regularly during long-term follow-up as recommended by your child’s healthcare provider (based on your child’s age when treated, the total amount of anthracyclines received and whether your child received chest radiation)
  • Annual check-ups that pay special attention to the heart
  • Cardiac stress testing about five years after certain high-dose radiation treatments or radiation plus anthracycline treatments and regularly thereafter as recommended

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