Q: What was the impetus for developing the Cardio-Oncology Program?
Dr. Brown: More and more people are surviving cancer, and this population is aging, which places people at increased risk for heart disease. In addition, some cancer treatments can cause damage to the heart. We wanted to meet the needs of these patients in a comprehensive way.
Q: How prevalent are heart problems among cancer patients?
Dr. Brown: It is a significant concern for physicians to be aware of with their cancer patients during treatment and afterward. Studies have shown that about 10% of cancer survivors will die of cardiovascular disease. Between 5% and 15% of cancer patients will develop heart failure after surviving cancer. Overall, cardiovascular disease is the leading cause of death in cancer survivors.
Q: What services does the Cardio-Oncology Program provide?
Dr. Brown: We offer a full range of services, including:
• Evaluation for and risk-reduction planning for cardiovascular disease before cancer treatment
• Coordination of a cancer regimen that reduces cardiovascular risk during treatment
• Cardiovascular health monitoring during treatment
• Advanced treatments for heart issues that may occur during, or years after, cancer treatment
Q: How does cancer treatment affect the heart?
Dr. Brown: The short answer is that cancer treatment can affect every part of the cardiac and vascular system. This is called cardiotoxicity. Some chemotherapies can cause cardiomyopathy or congestive heart failure. Radiation therapy concentrated in the chest region can trigger thickening of the blood vessels, calcification of heart valves, inflammation and artery occlusions. Other patients may develop high blood pressure or atrial fibrillation.
Q: How does the program approach treatment?
Dr. Brown: We develop a personalized plan for each patient, including identifying their risk for heart disease prior to starting cancer treatment. Planning and risk analysis may involve diagnostic testing, such as stress tests and imaging. We use the latest, noninvasive technology, such as 3D echocardiography and cardiac MRI, which often eliminates the need for invasive diagnostic procedures.
Q: What happens once cancer therapy is underway?
Dr. Brown: We’re on alert for any changes or abnormalities in the heart and use diagnostic imaging to track them. We also monitor patients for side effects that can occur from chemotherapy or radiation therapy. Throughout treatment, we partner with oncologists to recommend forms of chemotherapy that are safer and suggest when therapies might need to be paused.
Q: Are there special cardiac medications for cancer patients with heart problems?
Dr. Brown: No, the same drugs used with heart patients who do not have cancer are effective before, during or after cancer treatment.
Q: What specialists are part of the Cardio-Oncology Program?
Dr. Brown: Our program is made up of a multidisciplinary team that brings together specialists from cardiology, cardiac imaging, cardiothoracic surgery, hematology, medical oncology and radiation oncology. All told, we have about 10-15 cardiologists who see cancer patients, in addition to nurse practitioners. By assembling a multidisciplinary team, our goal is to manage heart problems without changing or interrupting the cancer treatment regimen whenever possible.
Q: What types of research are you doing?
Dr. Brown: The primary focus of our research now is on detecting cancer patients who are at higher risk of developing heart problems and preventing cardiovascular disease. We’re looking at past patient histories to find common factors that would allow us to identify these patients sooner and intervene earlier.
Q: How can providers access the Cardio-Oncology Program?
Dr. Brown: We will gladly work with referring providers to review a patient’s case or consult on treatment. We consider referring providers our partners in the care of these patients and work collaboratively to develop long-term care plans for patients at risk for cardiovascular disease during or following cancer treatment. For external providers, referrals or treatment consultations are available by calling 414-805-3666. Froedtert & MCW providers can make a referral request through Epic.
For Our Referring Physicians:
Academic Advantage of Cardio-Oncology Services
The Froedtert & MCW health network gives patients and their referring physicians a distinct advantage.
Contact our physician liaison team for more information about our Cardio-Oncology Program or if you would be interested in meeting with any of the cardio-oncology team members.