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The Science Nook on Cardio-Oncology

In light of American Heart Month, we feature the below research article on cardiovascular disease (CVD) mortality risk and cancer patients. There is an increased risk of CVD in cancer survivors related to mutual lifestyle and risk factors, cancer treatment, or “indirect results of cancer and its treatment (including cardio-respiratory deconditioning and weight gain)” [i].

Study

A Population-Based Study of Cardiovascular Disease Mortality Risk in US Cancer Patients

Journal: European Heart Journal

In this observational study, over 3 million cancer survivors were compared to the general US population using the Surveillance, Epidemiology, and End Results (SEER) program from the years 1973 to 2012. As stated in the article, “the SEER program is a network of population-based incident tumour registries, covering 28% of the US population, including incidence, survival, and treatment.” The authors looked at CVD mortality risk in multiple cancer sites related to continuous calendar year, age at time of diagnosis, and follow-up time after diagnosis [ii].

Findings

The authors found:

1. Cancer patients (all cancer sites) are at an elevated risk of dying from CVDs compared to the general population

2. The majority of deaths from CVD occur in those diagnosed with breast, prostate, or bladder cancer

3. The first year after endometrial cancer diagnosis poses a very high risk of dying from CVDs


For the Patient and Caregiver

These findings highlight the importance of programs focused on CVD prevention in cancer patients. This month’s Today’s Dietitian Magazine’s article on Cancer and Cardiovascular Care discusses prevention programs, as well as lifestyle factors to target, including physical activity and eating pattern. In addition to the lifestyle factor intervention resources found on our website related to oncology, check out the cardiovascular resources from the National Lipid Association and the University Health Network at the Toronto Rehabilitation Institute.

For the Healthcare Team

In 2019, The American Heart Association proposed a cardio-oncology rehabilitation model, taking cardiac rehabilitation (focusing on exercise, nutrition, tobacco use, and risk factor assessment) and applying it to cancer survivors at the highest risk of CVD [Gilchrist SC, Barac A, Ades PA, et al, 2019 as cited in reference i]. In addition to this proposal, other cardio-oncology guidelines include those from the American Society of Clinical Oncology. Screening cancer survivors for CVD risk and supporting cardio-oncology rehabilitation programs are crucial foci for CVD prevention in cancer survivorship.


References:
[i] Collins K. (2020). Cancer and cardiovascular care. Today’s Dietitian, 22(2):20.
[ii] Sturgeon KM, Deng L, Bluethmann SM, Zhou S, Trifiletti DM, Jiang C, Kelly SP, Zaorsky NG (2019). A population-based study of cardiovascular disease mortality risk in US cancer patients. European Heart Journal, 40(48):3889-3897. https://doi.org/10.1093/eurheartj/ehz766

Jenna Koroly, MS, RD, CDN

Jenna is a Registered Dietitian with a Master’s of Science in Nutrition and Exercise Physiology from Teachers College, Columbia University. She has been a part of the Savor Health team since October 2016, and gained further clinical knowledge in oncology while performing nutrition assessments at Northern Westchester Hospital and Amsterdam Nursing Home as a dietetic intern. Jenna provides nutrition counseling for patients in Medical Weight Management and Bariatric Surgery settings at Brigham & Women's Hospital in Boston. She is passionate about nutrition therapy and exercise for oncology patients.

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