- Page navigation anchor for Response to Dr Sharvill's letter - Cancer and the heartResponse to Dr Sharvill's letter - Cancer and the heartDear Dr Sharvill,Thank you for your letter in response to our article 'Cancer and the heart'.It's difficult to be sure of how many cardio-oncology specialists there are, but at present it is thought that the vast majority of these specialist clinics are in tertiary centres in major cities.As you rightly point out, clear information regarding long term cardiology follow up is important for both the patient and their GP, and as more patients are seen in cardio-oncology clinics it is hoped that this transfer of information will improve.There is a growing evidence for the use of ACE inhibitors and beta-blockers in anthracycline-induced and/or Trastuzamab-induced cardiomyopathy (in terms of improvement in cardiac function) and this is reflected in the ESC position paper.1 Although there are no data on how this functional improvement translates into clinical outcomes such as MACE, improvement in cardiac function enables continuation of chemotherapy and therefore is an important outcome in itself.Reference1. Zamorano J, Lancelotti P, Munoz DR, et al. ESC 2016 position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC committee for practice guidelines. The Task Force for cancer treatments and cardiovascular toxicity...Show MoreCompeting Interests: None declared.
- Page navigation anchor for Cancer and the heartCancer and the heartAwareness of this potential problem certainly needed highlighting, thank you. Outside the major cities how many cardio -oncology specialists are there? The numbers of long term survivors of cancer is thankfully huge and perhaps we need to ensure that any sign off at discharge from oncology should include written information for the patient (copied to the GP) about cardiac risks and future monitoring so they can take ownership of itSlightly more specifically we also need to be sure that there is good evidence for beta-blockers and or ace inhibitors in cancer related heart failure as we move towards increasing awareness of over prescribing and people will be increasing wanting to know NNT before taking on more medication.Competing Interests: None declared.