The program initially began as a pilot for patients with breast cancer and has now expanded to other cancer types. New cancer patients receiving certain higher risk treatments will undergo cardiovascular risk stratification, an ongoing process of assigning patients an individualized risk status. The physicians involved in the initiative have developed standardized protocols for prevention, detection and monitoring during treatment and how to treat cardiotoxicity if it occurs.
These protocols include:
- Monitoring patients using echocardiograms with strain imaging (to assess early left ventricular dysfunction) and cardiac biomarker blood testing
- Performing preoperative cardiovascular assessment before cancer surgery
- Determining cardiotoxicity risk depending on prescribed chemotherapy and radiotherapy, altering/substituting therapies as needed
- Screening for signs of previous cardiovascular disease
- Implementing guideline-directed medical therapy for patients with preexisting left ventricular dysfunction or cases that develop during treatment
- Discussing the importance of exercise with patients who are undergoing cancer treatment
- Initiating multidisciplinary discussions with patients’ oncologists regarding monitoring and treatment
