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The Heart of Cancer Care

By Dr. Lauren Zatarain, medical oncologist, Mary Bird Perkins – Our Lady of the Lake Cancer Center

Cardio-oncology is an emerging field dedicated to optimizing cardiovascular care received by cancer patients before, during and after their cancer treatment. Mary Bird Perkins – Our Lady of the Lake Cancer Center is at the forefront of this evolving field.

How cancer treatment can affect patients’ heart health

Although cancer treatments are constantly improving, some of the most effective cancer therapies can result in side effects related to patients’ hearts and other areas of the cardiovascular system.

In addition to the known side effects that radiation can have on the heart and other organs, studies have shown that some common cancer drugs can also impact the cardiovascular system. Cancer patients who may be most at risk include those over the age of 60, smokers, or patients with pre-existing conditions such as heart disease and diabetes. For instance, certain types of chemotherapy have been linked to a higher risk of developing a weakened heart muscle, heart valve issues or arrhythmias. Additionally, some leukemia patients who take blood thinners for heart problems face a risk of increased bleeding if they are treated with certain types of cancer drugs.

However, by studying the effects of chemotherapy and radiation therapy on cardiac health and working with other medical oncologists, radiation oncologists and cardiologists, we have the opportunity to proactively prevent or reduce damage to the heart before, during, and after treatment.

Physicians working together to help patients

A necessary component of a successful cardio-oncology program is regular communication among physicians. I recently joined a group of my peers from both oncology and cardiology to discuss the importance of this emerging field as Louisiana Cardiology Associates’ cardiologist Dr. Leon A. Cannizzaro, III hosted a multidisciplinary conference on the complexities of cardio-oncology.

Together with other specialists, Cancer Center medical and radiation oncologists and cardiologists are enhancing protocols and procedures to keep patients’ hearts healthy. As the field continues to grow, we’ll continue optimizing best practices as a multidisciplinary group for our patients.

Treating cancer while protecting patients’ hearts

Even though cardio-oncology is still a fairly new and evolving field, for many years the Cancer Center has focused on the challenge of keeping hearts healthy during treatment.

In addition to preventive strategies for all cancer patients like recommendations for a healthy diet, low-intensity exercise, and not smoking, the Cancer Center already has a number of preventive measures in place that protect patients’ hearts. These preventive measures include highly specialized radiation treatments to target specific tumors and spare healthy tissues and organs from the effects of radiation. Some examples of protective treatments are the SAVI treatment delivery device, state-of-the-art radiation technology, and the combination of brachytherapy with modern imaging.

One key technique that the Cancer Center has used in treatments for several years is “breath hold,” which requires breast cancer patients to take a deep breath during radiation treatment, moving the heart and diaphragm down and away from the beam of radiation. While this seems simple in theory, it requires complex calculations by the Cancer Center’s radiation oncologists and medical physicists to ensure the most effective and safe outcome.

Continuous innovation

The innovation to protect patients’ health while treating cancer continues. Recently, one of the Cancer Center’s medical physicists, Connel Chu, received a competitive grant for his project “BPAP for Radiation Therapy,” which transformed a bi-level positive airway pressure (BiPAP) machine typically used to treat sleep apnea to help lung cancer patients breathe in a more controlled way during radiation treatment. This reimagined technology has aided radiation oncologists in more precisely targeting tumors during treatments while avoiding healthy lung tissue and reducing side effects.

Restoring patients to whole health

With continued preventative measures, collaboration, communication, and innovation to coordinate patients’ treatment plans, we will continue improving the best and most personalized care for patients’ heart health today as well as in the future.

Lauren Zatarian

Dr. Lauren Zatarain is a medical oncologist, active clinical trial investigator, Clinical Assistant Professor of Medicine at LSU, and supporter of the survivorship program at Mary Bird Perkins-Our Lady of the Lake Cancer Center, where she currently serves on the Breast, Colorectal and Lung Multidisciplinary Care teams.