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Cancer Drugs May Damage the Heart - Chi Mei Hospital Initiates Asia's First Cardio-Oncology Care Program

The team tracked the cardiac index of breast cancer patients using echocardiography and serum analysis during the acute, subacute, and chronic phase of drug injection and notified the oncologist as soon as any abnormality is detected. By closely tracking the heart function, the hope is to allow patients to undergo chemotherapy without the need to worry.

Cancer Drugs May Damage the Heart - Chi Mei Hospital Initiates Asia's First Cardio-Oncology Care Program
As one of the possible side effects of chemotherapy is damage to heart function, Chi Mei Hospital introduced Taiwan's first cardio-oncology care program from western countries four years ago. For patients of breast cancer and lymphoma, the program successfully lowered the incidence rate of hypertension by 50%, and had zero cases of stroke, myocardial infarction, and deaths. The result led to an award from the Society of Cardiology and was published in a SCI journal (Acta Cardiol Sin 2016;32:550-559). It is the first achievement of its kind in Asia.

Chi Mei Hospital established its cardio-oncology team in 2014. The team tracked patients on doxorubicin chemotherapy and found that about 10 to 30% of the patients suffered from damage to the heart. If the cardiotoxicity due to the cancer treatment could be diagnosed early and its mechanisms understood, there is the possibility to treat the patients in a timely manner and improve their quality of life. As such, the team tracked the cardiac index of breast cancer patients using echocardiography and serum analysis during the acute, subacute, and chronic phase of drug injection and notified the oncologist as soon as any abnormality is detected. By closely tracking the heart function, the hope is to allow patients to undergo chemotherapy without the need to worry.

When patients with malignant tumors undergo chemotherapy, the focus is normally on the efficacy of the drug, the response of the tumor, and whether immediate side effects exist. However, as pointed out by Dr. Wei-Ting Chang of the Department of Cardiology at Chi Mei Hospital, chemotherapy drugs (including targeted drugs) may act on other cells in the body in addition to acting on the tumors. Specifically, cardiotoxicity occurs in 5 to 20% of the patients according to clinical statistics. These types of complications are severe and fatal but diagnosis and intervention are often too late.

Chi Mei Hospital's program allows doctors to perform appropriate treatments while keeping patients well informed of the condition of their hearts through follow-up phone calls and patient education. The precious data accumulated through this program also offer an opportunity for translational research. By separating the biomarkers in the serum and through advanced speckle-tracking echocardiography analysis, a method for detecting biomarkers in patients was established to allow early identification of patients susceptible to cardiotoxicity.

The Director of the Department of Cardiology at Chi Mei Hospital, Dr. Zhih-Cherng Chen, noted that the field of cardio-oncology began in Europe and the Americas over 10 years ago and its importance is now recognized worldwide. However, research in the field is rare in Asia. Unlike techniques such as cardiac catheterization and stents which are mainstream in cardiology, few young doctors are willing to devote themselves to the work. Nevertheless, "if it's the right thing to do, then it deserves the effort," as reflected in the cardio-oncology program that has already improved patient treatment and quality of life.

(Editing by Nicole Yang, Research Center for Biotechnology and Medicine Policy)
 
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