Development of cardio-oncology in Ukraine: rationale, organization and implementation in clinical practice

Abstract

Cardio-oncology is a new discipline in the field of medicine, with the main goal of identification, treatment and prevention of cardiovascular complications before, during and after cancer therapy. In recent years, progress in cancer treatment and the use of novel technologies has contributed to the improvement of cancer patients’ survival. The development of cardiovascular complications during anticancer treatment negatively affects the quality of life and worsens prognosis in potentially cured patients, especially in those with previous cardiovascular disease. Cardio-oncologists work in partnership with oncologists, oncohematologists, oncological surgeons, chemotherapists, radiologists, and primary care physicians. Proposed multidisciplinary approach makes it possible to provide the optimal anticancer treatment thereby improving the survival of cancer patients. In SI National Scientific Center «M.D. Strazhesko Institute of Cardiology» of NAMS of Ukraine, a center of cardio-oncology was established, which provides highly specialized outpatient and inpatient cardiac care to cancer patients. The main tasks of the cardio-oncology center are as follows: cardiovascular risk stratification before complex anticancer treatment: by operative intervention, before the beginning of polychemotherapy and radiotherapy, during treatment – by correction of cardiotoxic complications and comorbidities, monitoring of cardiotoxicity, primarily in patients with a high risk of cardiovascular complications, during and after anticancer therapy. The cardio-oncology center provides educational work, research and coordination activities to introduce the new subspecialty in the clinical practice, and collaborates with non-governmental organizations. Ukrainian Association of Cardiology has created a cardio-oncology working group, issued the first guidance on the management of patients with cardiotoxicity.