Women’s cardiovascular health – the cardio-oncologic jigsaw

Abstract

Improvements in cancer care have led to an exponential increase in cancer survival. This is particularly the case for breast cancer, where 5-year survival in Australia exceeds 90%. Cardiovascular disease (CVD) has emerged as one of the competing causes of morbidity and mortality among cancer survivors, both as a complication of cancer therapies and because the risk factors for cancer are shared with those for CVD. In this review we cover the key aspects of cardiovascular care for women throughout their cancer journey: the need for baseline cardiovascular risk assessment and management, a crucial component of the cardiovascular care; the importance of long-term surveillance for ongoing maintenance of cardiovascular health; and strong evidence for the beneficial effects of physical exercise to improve both cancer and cardiovascular outcomes. There is general disparity in cardiovascular outcomes for women, which is further exacerbated when both CVD and cancer co-exist. Collaboration between oncology and cardiac services, with an emergence of the whole field of cardio-oncology, allows for expedited investigation and treatment for these patients. This collaboration as well as a holistic approach to patient care and key role of patients’ general practitioners are essential to ensure long-term health of people living with, during and beyond cancer.

摘要

癌症治疗的进步导致癌症患者生存率呈指数增加。这种情况对于乳腺癌患者尤为显著, 在澳大利亚, 乳腺癌的5年生存率超过90%。心血管疾病（CVD）已经成为癌症幸存者中发病率和死亡率上升的主要原因之一, 它既作为癌症治疗的并发症, 也因为和癌症有一些相同的危险因素。在这篇综述中, 包括女性在整个癌症治疗中心血管护理的几个关键方面：进行基线心血管风险评估和管理的必要性, 这是心血管护理的重要组成部分；长期监测以持续维护心血管健康的重要性；以及体育锻炼对改善癌症和心血管结果的有力证据。对于女性, 心血管结果存在普遍的不平等, 当CVD和癌症共存时, 情况更为严重。肿瘤学和心脏学之间的合作, 以及心脏肿瘤学领域的出现, 可以增加对这些患者的调查和治疗。这种学科合作以及对患者整体护理、患者全科医生的重要角色, 都是对患者在患有、在癌症期间和癌症之后保持长期健康的有力保障。

Keywords:

• Cardio-oncology
• cardiovascular disease
• cancer
• risk factor management
• lifestyle factors

Acknowledgements

The funders had no role in the preparation of the manuscript or its content.

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

A. L. Sverdlov is supported by the National Heart Foundation of Australia Future Leader Fellowship [Award ID 106025]; D. T. M. Ngo is supported by the National Heart Foundation of Australia Future Leader Fellowship [Award ID 104814]; this work is supported in part by the NSW Health Cardiovascular Research Capacity Program Early-Mid Career Researcher Grant (to A. L. Sverdlov and D. T. M. Ngo) and Department of Health and Aged Care Medical Research Future Fund [MRF2017053] (to A. L. Sverdlov and D. T. M. Ngo). The funders had no role in the preparation of the manuscript or its content.