Specialized Cardiovascular Care for Cancer Patients

Led by Anju Nohria, MD, a cardiologist with special training in epidemiology and heart failure, and Javid Moslehi, MD, a cardiologist with additional training in molecular oncology, the Cardio-Oncology Program -- a joint initiative between the Division of Cardiovascular Medicine at Brigham and Women's Hospital and Dana-Farber/Brigham and Women's Cancer Center -- strives to minimize cardiotoxicity during cancer treatment and cardiovascular risks during cancer survival. Patients are seen at the Watkins Cardiovascular Clinic located at the Carl J. and Ruth Shapiro Cardiovascular Center at Brigham and Women's Hospital and at the Lance Armstrong Foundation Clinic at Dana-Farber Cancer Institute.

The Program offers specialized care for cancer patients with pre-existing cardiovascular conditions and the roughly 30 percent of cancer patients who develop cardiac complications from cancer treatment, including therapies with cardiovascular sequalae that both impede continued treatment and cause short- and long-term morbidity or mortality. Strategies used by specialists in the Program include:

* The use of cardioprotective medications, including beta blockers and ACE inhibitors, prior to the commencement of cancer treatment;
* Collaboration with medical oncologists to adjust dose or timing of cancer therapies;
* Evaluation of alternative cancer therapies with less cardiotoxic effects.

The above strategies have proven beneficial for patients diagnosed with cancer types that are most effectively treated with therapies that are known to contribute to cardiovascular conditions, such as cardiomyopathy. By beginning cardioprotective measures prior to the start of cancer treatment and closely monitoring or adjusting dose and timing, patients who may not have been eligible for certain cancer medications due to pre-existing cardiovascular conditions are able to benefit from the most appropriate cancer therapies.

Traditional cancer treatments associated with cardiac dysfunction include anthracyclines, radiation therapy, and newer agents, such as Herceptin. Specialists in the Program also are evaluating ways to prevent potential cardiovascular complications, such arrhythmias, cardiomyopathy, cardiac ischemia, and hypertension, resulting from certain novel molecular targeted therapies, including angiogenesis inhibitors.

Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School, is consistently ranked as one of the nation's leading hospitals. With a state-of-the-art cardiovascular center & orthopedic center of excellence, BWH is committed to excellence in patient care with expertise specialty of medicine and surgery.