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Cardiovascular Considerations After Cancer Therapy ...
Article: Cardiovascular Considerations After Cance ...
Article: Cardiovascular Considerations After Cancer Therapy: Gaps in Evidence and JACC: Cardio Oncology Expert Panel Recommendations
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The expert panel's summary on cardiovascular concerns post-cancer therapy highlights the growing awareness of cardiovascular disease (CVD) risks in cancer survivors, exacerbated by treatments like anthracyclines and chest radiation. Survivors face a 2 to 5 times higher risk of cardiovascular mortality. Risk factors include age at treatment, therapy types, and pre-existing cardiovascular conditions.<br /><br />Guidance recommends ongoing cardiovascular monitoring in cancer survivors, with all advised to undergo annual screenings and manage cardiovascular risk factors (CVRFs). High-risk individuals should receive more extensive cardiovascular evaluations, such as imaging. Known gaps include unclear risks of new cardiovascular disease types post-cancer treatment and the need for more specific predictive models and cost-effective screening methods.<br /><br />The report underlines that cancer therapy-related cardiovascular toxicity varies. Long-term management and monitoring of survivors, based on dynamic cardiovascular risks, are emphasized. Current tools like the ASCVD Risk Score may fall short in predicting actual cardiovascular risks due to cancer treatment impacts. While several screening models and guidelines exist, further validation and optimization for cost-effectiveness are required.<br /><br />Endocrine therapies for breast cancer, androgen deprivation therapies for prostate cancer, and radiation therapy also present significant cardiovascular risks. Emerging treatments like CAR-T cell and immune checkpoint inhibitors also necessitate ongoing monitoring due to potential cardiovascular toxicities.<br /><br />For childhood survivors, the report advocates for lifelong surveillance, especially in those exposed to high-risk factors like anthracyclines. Optimal management, therapeutic interventions, and integration within survivorship care models are crucial. The review emphasizes the necessity for clearer recommendations and deeper understanding through research to fill the existing gaps and optimize heart disease prevention and care for cancer survivors.
Keywords
cardiovascular disease
cancer survivors
anthracyclines
chest radiation
cardiovascular monitoring
risk factors
cardiovascular toxicity
screening methods
survivorship care
heart disease prevention
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