Guidelines for preventing heart disease caused by cancer therapy

At the end of August 2022, within the framework of the Congress of the European Society of Cardiology (ESC), guidelines for the prevention of the development of cardiovascular complications in people receiving therapy for cancer were published in the European Heart Journal. The guidelines were developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO), and the International Society of Cardio-Oncology (IC-OS). It is noteworthy that such a document is published at the ESC for the first time.

The published document was created primarily for medical professionals who manage patients with cancer. It contains specific recommendations for treatment before, during and after cancer therapy that can lead to cardiovascular complications. After all, as you know, cancer therapy can lead to the development or aggravation of cardiovascular diseases.

Preservation and control of heart health during cancer treatment is a key message of the guide. Patients should be educated on the potential risks and how to reduce them such as quit smoking, exercise at least 150 minutes per week, eat a healthy diet, and limit alcohol. Tight control of blood pressure, diabetes and high cholesterol is recommended.

The published paper provides recommendations for the diagnosis and treatment of cardiovascular side effects during cancer therapy. One common complication is left ventricular dysfunction, which can progress to heart failure. In the case of diagnosing such a pathology, it is recommended that oncologists and cardiologists make a joint decision on the safety and expediency of continuing cancer treatment.

For a number of patients, according to indications, observation during the first year after treatment is recommended. These include those who develop cardiovascular complications during treatment to assess whether the pathology is relieved after therapy is stopped. Some patients will need to stop therapy started during cancer treatment, while others will be recommended lifelong medication to treat cardiovascular complications. One of the side effects of cancer treatment is the delayed development of cardiovascular complications, which can develop up to 12 months after discontinuation of therapy, which also justifies the dynamic control of cardiovascular diseases. One of the authors of the document points out that long-term monitoring is aimed at early detection and treatment of heart disease in order to prevent severe complications in patients who successfully undergo cancer treatment.