It is not unusual for a cancer patient to also have a heart problem, as many forms of chemotherapy can damage the heart. However, around the world, there has been a rapid increase in changes in the way a patient is treated when doctors find both problems.
Dr. Edward Spangenthal is chief of cardiology at Roswell Park Cancer Institute and also a cardio-oncologist. He joins the treatment team for a patient anywhere from the beginning of treatment to much later stages, as chemotherapy can affect a patient's heart.
"The one point that I try to get across to community cardiologists is that you should not discount the heart problem just because there is cancer," Spangenthal says. "It's very common that we can treat the heart problem beforehand and then get them their cancer treatments. Whereas if we offer the cancer treatment before we remedy the heart problem, sometimes we throw the baby out with the bath water."
It is one of those medical conundrums, that one of the most studied and most used cancer drug, doxorubicin, has a known heart effect and its use has to be watched carefully. Spangenthal says both problems have to be monitored at the same time.
"Based on their risk factors and the chemotherapy agents that they might be receiving, so that we might be able to get them treatment earlier in the course of their therapy or in some cases if the toxicity is very severe, we might even decide to change course and either give them a different type of chemotherapy or perhaps offer them some protective measures," he says.
The problem is being studied around the world, with an Oxford University researcher presenting her work on how to check for heart damage during cancer treatment in a noninvasive way. The paper was presented to an international conference in London attended by Spangenthal.
He says it is too early to be sure about this research working, but it is a sign of how important the problem is. He and the Oxford researcher have emailed.