Abstract
BackgroundThe awareness of cancer therapy–related adverse cardiac effects is fueled by recent literature on cardiotoxicity incidence and detection strategies. Although this influences the sense of urgency, in current practice, cardiotoxicity monitoring and treatment is not structurally performed. With this study, we aimed to evaluate current perspectives on cardio-oncology and to assess needs, ultimately to determine an agenda for improvements in current practice.Material and methodsA national multidisciplinary 36-question survey was conducted. The survey was developed by a multidisciplinary team, theoretically based on an implementation checklist and distributed by email, through cardiology and oncology societies as well as social media.ResultsOne hundred ninety professionals completed the survey, of which 66 were cardiologists, 66 radiation oncologists, and 58 medical oncologists and hematologists. Many professionals were unaware of their specialisms’ cardio-oncology guidelines: 62.1% of cardiologists and 29.3% of the hematologists and medical oncologists respectively. Many cardiologists (N = 46; 69.7%), radiation oncologists (N = 45; 68.2%), and hematologists and medical oncologists (N = 38; 65.5%) expressed that they did not have sufficient knowledge to treat cardio-oncology patients and would either refer a patient or aspire to gain more knowledge on the topic.ConclusionThe field of cardio-oncology is advancing rapidly, with progress in stratification and detection strategies leading to the development of new guidelines and consensus statements. However, the application of these guidelines in current practice appears to be lagging. Professionals express a need for additional training and a practical guideline including risk stratification, monitoring, and treatment strategies. Multidisciplinary discussion and consensus on cardio-oncology care is vital to improve implementation of cardio-oncology guidelines, ultimately to improve cardiac care for oncology patients.
Highlights
The awareness of cancer therapy–related adverse cardiac effects is fueled by recent literature on cardiotoxicity incidence and detection strategies
Cardiovascular diseases (CVDs) constitute a common cause of morbidity and mortality in cancer survivors, which is partially explained by complications resulting from cancer therapy [2, 3]
Cardiologists, medical oncologists, hematologists, and radiation oncologists were invited for participation in this study and to fill out a 36-question survey between April and June 2021
Summary
The awareness of cancer therapy–related adverse cardiac effects is fueled by recent literature on cardiotoxicity incidence and detection strategies. This influences the sense of urgency, in current practice, cardiotoxicity monitoring and treatment is not structurally performed. Cardio-oncological care is often not a part of standard care yet, with overall low rates of cardiac care and a large heterogeneity between hospitals [7] This variation in applied care might stem from the novelty of this field and gaps in current knowledge might complicate implementation in clinical care. The absence of a validated risk stratification algorithm could lead to either over- or underutilization of care This in turn leads to the occurrence of potentially preventable cardiac side effects in cancer patients or the unneeded interruption of essential cancer treatments [5]. The extent of healthcare utilization has been studied, but little is known about the views on implementation and application of cardio-oncology care [7, 8]
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