title: Cancer survivorship: cardiotoxic therapy in the adult cancer patient; cardiac outcomes with recommendations for patient management.
abstract: Many types of cancer are now curable or, if not cured, becoming a chronic illness. In 2012, it was estimated that there were more than 13,500,000 cancer survivors in the United States. Late outcomes of these survivors are increasingly related to cardiovascular disease, either as a consequence of the direct effects of cancer therapy or its adverse effects on traditional cardiac risk factors (eg, obesity, hypertension, dyslipidemia, and diabetes mellitus). This article describes the therapies that have led to advances in cancer survival and the acute and chronic cardiovascular toxicities associated with these therapies. Recommendations are made for the surveillance and management of cancer survivors. Published guidelines on the subject of cardio-oncology are reviewed in light of clinical experience caring for these patients. To supplement this cancer-related knowledge base, appropriateness criteria and guidelines for cardiac care in the general population were extrapolated to cancer survivors. The result is a series of recommendations for surveillance and management of cardiovascular disease in cancer survivors.
authors: Memorial Sloan-Kettering Cancer Center, New York, NY. Electronic address: steingar@mskcc.org.
authors: Richard M
authors: RM
authors: Steingart
authors: Memorial Sloan-Kettering Cancer Center, New York, NY.
authors: Nandini
authors: N
authors: Yadav
authors: Memorial Sloan-Kettering Cancer Center, New York, NY.
authors: Carlos
authors: C
authors: Manrique
authors: Abramson Cancer Center, Philadelphia, PA.
authors: Joseph R
authors: JR
authors: Carver
authors: Memorial Sloan-Kettering Cancer Center, New York, NY.
authors: Jennifer
authors: J
authors: Liu
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000209:etiology / Q000628:therapy*; D002945:Cisplatin / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology / Q000628:therapy; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D017410:Practice Guidelines as Topic; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D017741:Survivors; D000068878:Trastuzumab; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000628:therapy
chemical_list: D018943:Anthracyclines; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D016190:Carboplatin; D011505:Protein-Tyrosine Kinases; D000068878:Trastuzumab; D002945:Cisplatin; D005472:Fluorouracil