«Portrait» of a cardio-oncological patient and the challenges of management in real clinical practice

Abstract

Objective: to present the cardiological status and difficulties encountered in the management of a cardio-oncological patient in real clinical practice. Materials and methods: over a two-year period, a cardiological examination was performed on 243 patients with various malignant neoplasms (MN) referred from an oncological dispensary. The following categories of patients with cancer were analyzed: before chemotherapy (CT, n=47), during CT (n=149), before radiation therapy (n=10), before surgery (n=23), and with uncertain management (n=14). Results: patients with cancer who were referred to a cardiologist for initial risk assessment had significant cardiac comorbidity. Almost 70% of patients had two or more cardiovascular diseases before CT. Patients with cancer, regardless of the chemotherapy they received, were more likely to be classified as having a moderate risk of cardiovasculotoxicity (CVT). In the study sample, more than 40% of patients experienced various manifestations of CVT during their chemotherapy. The article describes the structure of CVT manifestations, both individually and depending on the specific chemotherapy drug used. It also highlights the challenges that cardiologists may face when assessing the risk of CVT, radiation-induced cardiotoxicity, and perioperative cardiovascular risk in patients with cancer. Conclusion: at the current stage, as part of the comprehensive management of patients with malignant neoplasms, a cardiologist should have extensive knowledge of the assessment of risk and clinical manifestations of various cardiovascular complications that occur during the use of antitumor treatment. This will allow for the effective implementation of the necessary therapy and improve the prognosis of patients with malignant neoplasms.