The rise of cancer and cardiac incidence within the country calls for a specialised focus on onco-cardiology in healthcare. There is need for effective screening strategies to keep check of cancer patients who undergo chemotherapy. Chemotherapy ia said to cause a risk of heart diseases. On the occasion of World Heart Day, Dr Ankur Phatarpekar, Interventional Cardiologist and Consultant Cardiologist at Fortis Raheja, Wockhardts Hospital and Breach Candy Hospital explains the significance of onco-cardiology
Why is the understanding of onco-cardiology critical for the effective care of cancer patients?
Since the advent of effective chemotherapy and advances in oncology care, life span of patients with cancer has increased. There are short term as well as long term implications of chemotherapy especially on the heart, which is seen long after the cancer treatment is over. So highlighting the need for effective cardiac follow up is necessary.
Doctor, tell us the impact of chemotherapy on the heart?
There are wide ranging effects from heart attacks to heart failure, heart blocks which slow the rhythm of the heart to fast terminal heart rates which can be fatal. Each chemotherapy agent is unique in the way it affects the heart. Oncocardiac care requires a different skill set to diagnose and treat the disorder.
Currently, what is the percentage of onco-caddiologists in India?
Very few, if at all any practice this subspeciality of cardiology. In India, there is no data to back the number of onco-cardiac doctors.
What precautions should healthcare providers take in order to avoid damage to the heart cell while providing chemotherapy?
Healthcare providers need to focus on preoperative screening of risk factors for cardiac disease as well as screening for baseline heart function. Monitoring of cardiac rhythm during and post chemotherapy is a must. If subtle decrease in heart function is found then is it necessary to treat with cardiac protective drugs to prevent further worsening.
Which are the chemotherapy drugs that cause the maximum damage?
Anthracycline group of drugs which is treatment of choice from breast cancer might cause heart failure. Flurouracil which is the mainstay of treatment of colon cancer causes heart attacks. There are many more chemotherapy agents which affect the heart in different ways.
Is there enough research done in this field in India?What kind of research is required in this field?
This subspeciality has not been given due importance due to lack of awareness amongst patients and even medical fraternity. A lot needs to be done to understand the mechanisms which causes this disease which will lead to effective treatment and preventive strategies in the future.
Clinical as well as molecular research is needed.
Can a heart condition in a patient lead to diagnosis of cancer? Can heart diseases have any connection with undetected cancer?
There is no direct correlation of heart disease giving rise to cancer. However, we have one across few cases with clots in the arteries being diagnosed first which on work up were later diagnosed to have underlying cancer.
What is the message that you would like to give oncology experts and cardiologist.
Keep a high degree of suspicion for chemotherapy induced cardiac issues. Effective screening strategies will go a long way in mitigating the burden of cardiac disease in this subset of patients.
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