HJBR Jan/Feb 2021

HEALTHCARE JOURNAL OF BATON ROUGE I  JAN / FEB 2021 51 Leon Cannizzaro, MD Cardiologist Louisiana Cardiology Associates for further assessment and management with the goal being to minimize and ideally avoid any interruption to cancer treatment while protecting the heart and cardiovas- cular system. With the rapid evolution made to cancer treatments in recent years, our knowledge of potential cardiac toxicities is always be- ing updated. Some of the most common and effective cancer treatment regimens with potential cardiac toxicity have always included anthracyclines such as doxoru- bicin (also known as Adriamycin or the “Red Devil”) and HER-2 inhibitors such as Herceptin. In addition, a history of ex- tensive radiation therapy to the chest even decades ago can result in long-term effects on the heart and cardiovascular system. Certain cancer therapies can cause cardi- ac-related side effects such as significant high blood pressure, which can be dan- gerous in any patient but even more so in those with high risks. More recently, with newer immunotherapies, virotherapies and specific targeted therapies, the profile of potential cardiac toxicities is expanding. Lastly, combination therapies can include a multitude of these potentially toxic agents that impact long-term cardiac toxicity. Because research continues to be nec- essary in order to advance cancer and car- diac care, cardio-oncology research teams are actively enrolling patients in national clinical trials to help further our under- standing of cardiac toxicity and to enhance patient care. We are also adventuring be- yond just cancer treatment and beginning to explore how radiation therapy might be able to noninvasively treat cardiac patients with certain underlying heart rhythm dis- orders. More broadly, cardio-oncology is an ex- citing and emerging frontier that provides a good example of how cancer medicine has shifted over time. Decades ago, cancer was frequently a fatal diagnosis, and the focus of therapy rightfully was squarely on oncologic treatment without an under- standing, or sometimes care for, the ad- verse downstream effects that might result. Long-term survival from the cancer itself was still a challenge. Today, our advanced resources and effective treatment options have expanded, and survival has improved across the majority of cancers. We are now entering a paradigm in which not only the cancer must be treated, but we must now ensure the long-term well-being of the patient thereafter. Cardio-oncology is a re- cent step toward meeting this quest. n Leon Cannizzaro, MD is a cardiologist at Louisiana Cardiology Associates. He is the medical director of Echocardiography for Louisiana Cardiology As- sociates and also the program lead for Mary Bird Perkins – Our Lady of the Lake Cancer Center’s Cardio-Oncology Program and a member of the medical staff of Our Lady of the Lake Heart and Vascular Institute. “The purpose of a cardio-oncology clinic, now available at the more advanced cancer centers, is to monitor patients before, during and after cancer treatment in order to prevent or minimize potential cardiac injury while giving at- risk patients the best chance to complete optimal cancer therapy.”