For many years, the immediate priority in cancer care was treating the disease and helping patients survive it. Advances in screening, diagnosis and treatment have changed that picture. More people are now living for years after cancer treatment, bringing greater attention to what their health looks like beyond the initial treatment period.
This has also changed the way survivorship needs to be approached. Cancer follow-up is not only about watching for recurrence. It also needs to consider other health problems that can affect a person’s recovery and quality of life. Heart health is an important part of this discussion.
Some cancer treatments can affect the heart and blood vessels. At the same time, patients may already have conditions such as high blood pressure, diabetes, abnormal cholesterol or excess weight. Looking at these factors before treatment can help doctors understand a patient’s cardiovascular health and decide whether additional monitoring may be needed.
This is where cardio-oncology has an important role.
Understanding the risks before treatment
Cancer treatment has changed considerably, with chemotherapy, targeted therapies, immunotherapy, hormonal treatment and newer radiation techniques now used across different cancers. These treatments have improved outcomes for many patients. However, their effects on the cardiovascular system can vary, particularly in people who already have heart-related risk factors.
Apollo’s Health of the Nation Report 2026 found that among more than 5.3 lakh people who underwent corporate health assessments, 81% were overweight or obese, 55% had abnormal cholesterol, 45% had prediabetes or diabetes and 25% had high blood pressure. The average age was 38.7 years.
These figures are not from cancer patients, but they show how frequently cardiovascular and metabolic risk factors are seen in people undergoing preventive health checks.
For someone about to begin cancer treatment, knowing about existing blood pressure, diabetes, cholesterol or heart disease can help establish a useful baseline. It can also help identify patients who may need closer cardiovascular monitoring during treatment.
A healthy-looking heart may not tell the whole story
Cardiovascular disease does not always produce symptoms in its early stages. This can make assessment particularly important when a patient is already undergoing cancer treatment, where symptoms such as tiredness or breathlessness may have more than one possible cause.
Among more than 1,100 people without symptoms who underwent coronary calcium scoring, 45 per cent were found to have calcium deposits in their coronary arteries.
This does not mean that every cancer patient needs extensive cardiac testing. The decision depends on the patient’s age, medical history, existing risk factors and the treatment being planned. For selected patients, however, a baseline cardiac assessment can provide a useful point of comparison during later follow-up.
Cancer treatment and heart care need to be considered together
Breast cancer illustrates why this connection matters. The Health of the Nation Report 2026 identified breast cancer in one out of every 359 women who underwent mammography, with an average age of detection of 51 years.
At the same time, research published in the Journal of the National Cancer Institute found that breast cancer patients treated with anthracyclines and/or trastuzumab had a 53 per cent higher risk of cardiovascular disease than breast cancer patients who did not receive chemotherapy.
These medicines remain important cancer treatments. The finding instead points to the need for appropriate cardiovascular monitoring alongside cancer therapy, particularly in patients with additional risk factors.
The connection can also extend to patients who have not yet developed cancer but carry an inherited cancer risk. Women with BRCA1 or BRCA2 mutations may be advised to undergo risk-reducing salpingo-oophorectomy to lower their risk of ovarian and related cancers. When this is performed before the natural age of menopause, it results in premature menopause. Premature surgical menopause has itself been associated with a higher risk of cardiovascular disease, making long-term heart health an important consideration in survivorship and preventive cancer care.
Oncology and cardiology therefore have an important opportunity to work more closely in selected cases. A patient’s cancer treatment, cardiovascular history and risk profile can be considered together when deciding the level of monitoring required.
Survivorship needs to continue after treatment
Finishing cancer treatment is an important milestone, but it does not necessarily mean that health monitoring can stop.
An analysis of more than 1.79 lakh people followed over 10 years found that, among those who initially had normal health assessments, changes in weight and blood pressure appeared at around 1.4 years. Changes in cholesterol followed at about 2.8 to 3 years, while changes in blood sugar appeared at around 3.3 years.
For cancer survivors, this reinforces the need to keep an eye on cardiovascular and metabolic health after active treatment. Depending on the patient’s treatment history and risk factors, follow-up may include blood pressure, weight, blood sugar and cholesterol checks, with cardiac assessment where required.
Building a more connected approach
A stronger survivorship pathway can begin before cancer treatment and continue after it. Existing cardiovascular risks can be assessed at the outset, patients can be monitored according to their treatment and individual risk, and relevant health concerns can continue to be addressed after treatment.
Clear communication between oncology, cardiology and primary care can support this process. Keeping a record of the cancer treatment received and any cardiovascular concerns identified can also make follow-up easier when patients move between specialties.
The aim is not to subject every cancer survivor to additional investigations. It is to identify those who may be at greater risk and ensure that appropriate care is available when needed.
As more people live beyond cancer, survivorship is becoming a larger part of cancer care. World Heart Day offers an opportunity to recognise that this journey also includes protecting cardiovascular health.
For patients, successful cancer care should ultimately mean more than completing treatment. It should also include the opportunity to maintain good health in the years that follow. Cardio-oncology can help bring that longer-term perspective into routine cancer care.