Can cancer treatments affect cardiovascular health?

Cancer treatments such as chemotherapy, targeted therapy, immunotherapy, and radiation to the chest can aggravate existing cardiovascular diseases in a cancer patient, and can also result in cancer patients developing treatment related cardiovascular problems.

If conditions such as diabetes, high blood pressure, high cholesterol, and obesity which are associated with cardiovascular disease, are not detected and managed optimally during cancer treatment, it may even result in death from cardiovascular complications rather than the cancer itself.

How cancer treatments affect cardiovascular health

The cancer patient may achieve a fantastic outcome from the cancer treatment, but may succumb to cardiovascular complications if the cardiovascular risk factors and cardiovascular disease itself has not been timeously detected and treated.

“Therapies against cancer, even if increasingly effective and sophisticated, can cause high incidences of damage even to a healthy heart, or they can worsen the cardiac function when it is already impaired. As the number of survivors grow so does the number of patients living with the late effects of cancer related cardiotoxicity.”

Extract from the International Cardio-Oncology Society (IC-OS) website

What role does cardio-oncology care play in the outcomes of cancer patients?

The first and foremost focus of cancer treatment is understandably on treating and curing the cancer.

Assessment and ongoing monitoring of the cardiovascular health of cancer patients prior, during and after treatment enable timeous intervention to address possible cardiac risks and minimise negative health consequences for these patients in the long term. This is especially important for those most at risk of the cancer treatment impacting their heart health.

What role does cardio-oncology care play in the outcomes of cancer patients?

The earlier high risk cancer patients are identified for cardiotoxicity, the sooner the cardio-oncologist can provide appropriate treatment to mitigate the risk of a cardiac incident or debilitating cardiac conditions that may result from the cancer treatment.

If the patient’s cancer treatment involves radiation to the chest, damage to the heart muscle, heart valves, coronary arteries and pericardium may only manifest a few years after completion of the radiation treatment. Ongoing surveillance of these patients is therefore very important.

“It is no use treating a patient for cancer, only for them to suffer a potentially fatal cardiac incident or develop a debilitating cardiac condition as a result of the cancer treatment.”

Cardiologist and cardio-oncologist, Dr YT (Trishun) Singh

Who will benefit from
cardio-oncology care?

Cancer patients who suffer any of the following cardiovascular conditions and are undergoing cancer treatment can benefit from cardio-oncology care:

  • Those with an existing cardiac condition such as ischaemic heart disease, heart valve dysfunction, cardiac arrhythmias and those prone to arterial and venous thrombosis.

  • Those who have co-morbidities (other medical conditions) such as diabetes, high blood pressure, high cholesterol, and obesity.

  • Smokers.

  • Those who develop treatment related cardiovascular problems

Who introduced cardio-oncology care into South Africa?

In a first for the African continent, a cardio-oncology unit was established at Netcare uMhlanga Hospital in KwaZulu-Natal, South Africa in 2019, by cardiologist and cardio-oncologist, Dr YT (Trishun) Singh, working closely with Durban based Dr Ria David, the only medical oncologist in KwaZulu-Natal, and surgeon Dr Ines Buccimazza, who heads the breast cancer and endocrine unit at the Inkosi Albert Luthuli Hospital/Nelson Mandela School of Medicine.

Following extensive cardio-oncology training, Dr Trishun Singh has been certified as a cardio-oncologist by the International Cardio-Oncology Society (IC-OS) and is president of the Cardio-Oncology Society of Southern Africa (COSOSA). He also represents COSOSA as the South African Chapter of IC-OS.

Netcare uMhlanga Hospital was certified as an international cardio-oncology centre of excellence by IC-OS in November 2022.