OhioHealth Specialists Care for the Hearts of Local Cancer Patients
OhioHealth Mansfield Hospital aims to reduce heart and vascular complications in patients undergoing treatment for cancer. The hospital’s cardio-oncology program is the only one of its kind in the region and is a collaborative effort between cancer and heart specialists, who work with patients before, during and after cancer treatment to address the patients’ ongoing needs and mitigate side effects.
“We want to be able to treat our patients through to completion, giving them the best care we can,” says oncologist Dr. Katherine Exten, who leads the program with cardiologist Dr. Viren Patel.
Cancer treatments, including both chemotherapy and radiation, can cause a variety of heart and vascular side effects, known collectively as cardiotoxicity. Complications include heart failure, irregular heartbeat, blood pressure abnormalities, blockages in blood vessels of the legs and a condition known as pericardial effusion, which is a buildup of fluid around the heart. In some cases, patients must take a break from cancer therapy temporarily or in rare cases, stop entirely.
Chemotherapy agents can cause cardiotoxicity, because cells within the heart muscle contain receptors that react with drugs, which kill cancer cells, Dr. Patel says. Radiation also causes side effects, such as chest pain and spasms due to coronary artery blockages. He adds that even with newer, more targeted therapies, doctors must be vigilant to guard against complications.
Patients in the cardio-oncology program benefit from continual communication between physicians. This allows patients to continue optimum chemotherapy safely. “We work very closely with cardiologists to monitor medications and mitigate side effects,” Dr. Exten says. “Having a direct line of communication with cardiologists is hugely important for us in order to be able to address any potential issues in a very efficient manner.”
Dr. Patel says a goal of cardio-oncology programs is to include cardiologists, because they have more expertise with cardiotoxicity and have knowledge of the newest medicines. He says, “For providers, the oncologists know who to call to streamline the process. From the patients’ perspective, they appreciate that we are treating them as a whole person.”
The field of cardio-oncology is relatively new and has lacked a standard set of protocols for follow-up, lab work and tests, such as echocardiograms. Dr. Exten says, “This didn’t exist. It was done institution by institution. Mansfield Hospital developed the standards for OhioHealth’s system program.”
For cancer patients with pre-existing conditions, such as heart failure or coronary artery disease, collaboration between specialties begins before treatment. Referring oncologists “come to us beforehand to make sure we keep a close eye on their patients and make sure they are receiving the kinds of medicines likely to prevent complications,” Dr. Patel says. “Throughout cancer treatments, our job is to make sure the side effects of the therapy aren’t worse than the disease we are treating.”
The cardio-oncology program is one component of Mansfield Hospitals’ comprehensive, multidisciplinary approach to treating cancer patients. Other services include medical, surgical and radiation oncology specialists; diet, nutrition and weight management; social work and counseling; and pain management, palliative care, hospice and breast-cancer survivor programs.
For more information, go to https://www.ohiohealth.com/services/heart-and-vascular/our-programs/clinical-cardiology/cardio-oncology.