ACC 2015: Pamela Douglas discusses the challenges of cardio-oncology

March 16, 2015 – Douglas lectured on the importance of cardio-oncology from a cardiologist’s perspective.

The DCRI’s Pamela Douglas, MD, delivered a lecture on the importance of pamela-douglas-newscardio-oncology from a cardiologist’s perspective Monday morning at the annual Scientific Sessions of the American College of Cardiology (ACC) in San Diego.

As cancer survival rates have improved over the past few decades, researchers and clinicians have noted that these patient are developing cardiovascular ailments, including myocardial ischemia, myocardial infarction, stroke, and congestive heart failure. Some of these conditions have previously been linked to therapies used to treat cancer patients, but some newer therapies and longer survival has increased the concern. Cancer patients now represent one of the largest and fastest-growing populations at risk for premature heart disease.

To address these complications, a new medical subspecialty has arisen in recent years: cardio-oncology. Cardiologists and oncologists who work in this nascent field face a number of challenges, Douglas said in an interview prior to her lecture. Not least among them is the fact that there are relatively few clinical guidelines, training programs, or clinical management tools devoted to cardio-oncology.

“We need to develop the evidence base and expand the research being done in this area,” she said. “Right now, most people are operating just from a common sense perspective rather than from proven strategies. Cardiologists and oncologists need to communicate and collaborate effectively to provide optimal care.”

Improving the state of cardio-oncology studies and treatment is essential, Douglas said, because the two disciplines are inextricably linked in both cancer and heart patients. Good heart health is essential to improving outcomes, she noted.

“Ideally, we want patients to be in the best shape possible before they begin cancer treatment so that cardiovascular issues don’t limit their cancer treatment options,” Douglas said. “And when the cancer is cured or in remission, we don’t want cardiovascular disease to limit the quality or quantity of their life.”

There have been some recent developments toward advancing the field, she said. The ACC and the American Society of Clinical Oncology have begun to collaborate on a number of projects, and this year’s ACC meeting includes several working groups devoted to the subject. Even so, Douglas said, there is still much to do.

“In 5 years, cardio-oncology will likely be identified as a sub-specialty with dedicated training,” she said. “There will be-oncology fellowships and guidelines and documents to help clinicians know the evidence and to help them provide the best care.

“It is a tremendous opportunity and it is also a tremendous recognition of the need and importance for this specialty area.”