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Cancer and Cardiac

Hussein Rayatzadeh is a physician specializing in cardiology and cardio-oncology at Tallahassee Memorial Hospital. He spoke with FLORIDA TREND about the challenges associated with treating cancer patients who also suffer from heart ailments. He gained expertise in cardio-oncology during a fellowship at MD Anderson Cancer Center in Houston.

  • The Connection: “Cardio-oncology is a new and growing field. And as an increasing number of cancer therapeutics and drugs come into the market, and the more we know about them, the more we know about the risks of cardiotoxicity and the impact it has on cardiovascular disease and the significant cause of morbidity and mortality in cancer populations.”
  • Recognizing the Risks: “Now there’s a nationwide effort to characterize these risks, evaluate the patient before starting the cancer therapeutics, monitor them for those potential side effects and approach and target them before it’s too late. This is the third year of our cardio-oncology program at TMH, and it has been very successful. Our oncologists realize the value of having this systematic program here.”
  • Treatments: “When cancer patients arrive for treatment, they generally fall into three categories:

The first is the patient with a higher risk of developing cardiovascular diseases because of risk factors that include diabetes, anemia and elevated blood pressure, but they haven’t developed them yet.

The second category is the patient who has a preexisting cardiovascular disease. For example, they’ve had a heart attack; they’ve had congestive heart failure or an irregular heartbeat and they’ve already seen a cardiologist. Those are the patients who we need to be sure, before starting them on those cancer treatment agents, that they are stable from a cardio standpoint. We are going to monitor them very closely to make sure they don’t end up in an increased toxic stage just because of that risk factor that’s been added to their health profile.

The third category includes patients who develop cardiotoxicity or some other cardiac issues, such as arrhythmia or congestive heart failure, during the therapy and are getting treatment for those cardio-vascular problems during the cancer therapy. So, this third category is more of a treatment stage where the other two are preventive.”

  • Making Progress: “The number of cancer therapeutics available today has increased significantly, and the numbers of cancer survivors are tremendously higher compared to two or three decades ago. Obviously, that’s because we have many more cancer therapeutic agents, and the more that we have, the higher the chance of risk associated with them.”