After reviewing results from a study suggesting that cancer patients who undergo chemotherapy and radiation therapies have a higher risk of suffering heart disease later in life, a leading cardiologist, Dr. Cindy L. Grines, is at the forefront of developing a new medical specialty called cardioncology.
The new collaborative specialty with both heart and cancer doctors was already endorsed by the American College of Cardiology and the American Society of Clinical Oncology. The review article was recently published in the journal Catheterization and Cardiovascular Interventions, and is titled “SCAI Expert consensus statement: Evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory.“
Grines, vice president of the Detroit Medical Center (DMC) Heart Hospital, who is also a professor of medicine at the Wayne State University School of Medicine, said in a press release, “The data in this new study are clear and compelling. They show that cancer therapy is a major risk factor for later heart problems. We’ve known all along, of course, that such therapies as chemo and radiation take a toll on heart tissue and blood vessels – but this latest review of the evidence tells us that cancer therapy can be every bit as important (as a risk factor for heart disease) as smoking or high cholesterol.”
Grines, a veteran cardiologist and the first to induce the growth of heart tissue directly into a living heart by inserting stem cells, is also co-author of the new study, where it is shown that chemotherapy and radiation often cause “significant injury to the vasculature (heart and blood vessels), resulting in angina, acute coronary syndromes (ACS), stroke, critical limb ischemia, arrhythmias, and heart failure.”
“During the past 15 years or so – thanks mainly to powerful new drugs and improved radiation technology – we’ve seen survival rates in areas like breast cancer climb to well above 90 percent. That’s a wonderful improvement for cancer patients, of course, but because it has been relatively recent, the data on how chemo and radiation elevate heart disease risk factors hadn’t fully caught up yet. But now the numbers are coming in, and this new study really underlines the importance of understanding how cancer therapies are elevating the risks for heart disease and heart attack in surviving cancer patients,” Grines said.
The impact of cancer therapies is highlighted in the study where authors noted, “adult survivors of childhood malignancies with a history of chemoradiation had a 7-fold higher mortality rate, 15-fold increased rate of heart failure, 10-fold higher rates of cardiovascular disease and 9-fold higher rates of stroke compared to their siblings.”
The DMC Heart Hospital is actively developing the cardioncology program, and there is already equipment prepped for screening potential cancer-therapy patients for heart issues that could be affected by chemotherapy or radiation before such potentially risk-elevating procedures get underway.
“The screening is very important. But I also think it’s very important right now for physicians to be aware that cancer patients who’ve had chemotherapy or radiation will often face a significantly elevated risk factor for heart disease. In my view, cancer treatment can be every bit as much a risk factor as somebody who’s a heavy smoker, or somebody with severe diabetes,” Grines said.
DMC Heart Hospital President Dr. Theodore L. Schreiber said the findings have: “a very hopeful indication for all of us that the Heart Hospital is now leading the way in this crucially new important area of research and clinical treatment. The vital connection between research and treatment can be seen clearly in this important new study … and it’s encouraging to know that we’re now fully equipped to care for cancer patients who need to be screened and perhaps treated at some point for potential heart ailments linked to their cancer care.”
