Heart intertwined with DNA, symbolizing cardio-oncology and protection during cancer treatment.

Cardio-Oncology: Protecting Your Heart During Cancer Treatment

Avery Sinclair in Health & Wellness August 2025 • 4 min read.

"A comprehensive guide to understanding and mitigating cardiotoxicity, ensuring heart health during cancer therapy."

Cancer treatments have advanced significantly, improving outcomes for many patients. These treatments often combine established therapies like anthracyclines and radiation with newer, molecularly-targeted therapies such as tyrosine kinase inhibitors and immune modulators.

Comprehensive care for cancer patients now includes considering the potential impact of these treatments on various organ systems, particularly the cardiovascular system. This awareness has led to the development of cardio-oncology, a field focused on identifying, monitoring, treating, and preventing cardiovascular issues that may arise during cancer therapy.

This article provides a detailed overview of the cardiovascular effects of various cancer therapies, offering insights into selecting appropriate imaging modalities and strategies to protect and manage heart health throughout cancer treatment.

Understanding Anthracycline Cardiotoxicity and Protective Measures

Heart intertwined with DNA, symbolizing cardio-oncology and protection during cancer treatment.

Anthracyclines, a class of drugs widely used in cancer treatment, are known for their potential to cause cardiotoxicity, making it a significant concern for patients. While patients receiving anthracyclines may experience a small change in left ventricular ejection fraction (LVEF), anthracycline cardiotoxicity is defined by more substantial decreases in LVEF, indicating impaired heart function.

Cardiotoxicity from anthracyclines can manifest in two forms: acute and chronic. Acute cardiotoxicity typically occurs during or shortly after the first cycle of treatment and can range from an asymptomatic decrease in LVEF to severe conditions like congestive heart failure. Chronic cardiotoxicity, on the other hand, may not improve and is often linked to the cumulative dose of the drug.

Risk Factors: Older age (over 65), being female, pre-existing cardiovascular disease, hypertension, previous exposure to cardiotoxic therapies, and high individual doses of anthracyclines.
Oxidant Stress: Anthracyclines can cause oxidant stress in heart cells, leading to the formation of harmful free radicals. This process can damage cardiomyocytes and impair mitochondrial function.
Monitoring: Regular monitoring of LVEF is essential during anthracycline therapy. Newer non-invasive methods are being developed to detect subclinical left ventricular dysfunction. Serum biomarkers like troponin I may also help identify cardiotoxicity earlier than changes in LVEF.

Treatment for anthracycline cardiotoxicity includes standard heart failure therapies like ACE inhibitors or ARBs, beta-blockers, and diuretics. Dexrazoxane, an iron chelator, can protect against cardiotoxicity at high cumulative doses. Prevention strategies are critical to minimizing the risk of long-term heart damage.

Integrating Cardio-Oncology for Better Patient Outcomes

As cancer therapies continue to evolve, the importance of integrating cardio-oncology into patient care becomes increasingly clear. Understanding the potential cardiovascular toxicities associated with various treatments allows cardiologists to select the most appropriate monitoring strategies and preventive measures. By working collaboratively, oncologists and cardiologists can optimize patient outcomes, ensuring both effective cancer treatment and long-term heart health.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s12350-018-01470-5, Alternate LINK

Title: Cardio-Oncology: Understanding Cardiotoxicity To Guide Patient Focused Imaging

Subject: Cardiology and Cardiovascular Medicine

Journal: Journal of Nuclear Cardiology

Publisher: Springer Science and Business Media LLC

Authors: Raymond Russell

Published: 2018-11-15

Everything You Need To Know

What is cardio-oncology, and why is it so important in cancer treatment?

Cardio-oncology is a specialized field that focuses on identifying, monitoring, treating, and preventing cardiovascular issues that may arise during cancer therapy. It is essential because cancer treatments can sometimes harm the cardiovascular system. By integrating cardio-oncology into cancer care, healthcare professionals can optimize patient outcomes, ensuring both effective cancer treatment and long-term heart health. This involves understanding the potential cardiovascular toxicities associated with various treatments and selecting appropriate monitoring and preventive measures.

What are anthracyclines, and why is there a concern about cardiotoxicity with these drugs?

Anthracyclines are a class of drugs widely used in cancer treatment, but they are known for potentially causing cardiotoxicity. This is significant because cardiotoxicity can lead to impaired heart function, which can manifest as a substantial decrease in left ventricular ejection fraction (LVEF). The implications include the need for careful monitoring during anthracycline therapy, and the implementation of preventive strategies to minimize the risk of long-term heart damage. This may also involve using alternative treatments when possible.

How does anthracycline cardiotoxicity manifest, and why is it important to understand the different ways it can present?

Anthracycline cardiotoxicity can present as acute or chronic. Acute cardiotoxicity occurs during or shortly after the first cycle of treatment, potentially leading to conditions like congestive heart failure. Chronic cardiotoxicity may not improve and is often linked to the cumulative dose of the drug. Understanding these different forms is crucial for timely intervention and management of heart health during cancer treatment. Monitoring strategies and treatment approaches may differ depending on whether the cardiotoxicity is acute or chronic.

What factors make someone more likely to experience cardiotoxicity when receiving anthracyclines?

Several factors increase the risk of cardiotoxicity in patients receiving anthracyclines. These include older age (over 65), being female, pre-existing cardiovascular disease, hypertension, previous exposure to cardiotoxic therapies, and high individual doses of anthracyclines. Awareness of these risk factors allows healthcare providers to identify patients who may require closer monitoring and more aggressive preventive measures to protect their heart health during cancer treatment. These patients may also benefit from alternative treatment regimens if available.

How can healthcare providers monitor heart health during anthracycline therapy, and what steps can be taken if cardiotoxicity is detected?

Healthcare providers can monitor LVEF, a measure of heart function, during anthracycline therapy to detect cardiotoxicity. Newer non-invasive methods are being developed to detect subclinical left ventricular dysfunction, allowing for earlier intervention. Serum biomarkers like troponin I may also help identify cardiotoxicity earlier than changes in LVEF. Regular monitoring and early detection are crucial for managing and preventing severe heart damage during cancer treatment. Treatment for anthracycline cardiotoxicity includes standard heart failure therapies like ACE inhibitors or ARBs, beta-blockers, and diuretics. Dexrazoxane, an iron chelator, can protect against cardiotoxicity at high cumulative doses.