ABSTRACT
Los pacientes que sobreviven a un cáncer tienen una menor supervivencia a largo plazo, en parte debido al incremento de las enfermedades cardiovasculares (ECV). Hasta el 30% de los fallecimientos de pacientes con cáncer pueden ser de causa cardiovascular. El cáncer puede causar ateroesclerosis por diferentes mecanismos, los más frecuentes son las secuelas de los fármacos antitumorales, la radioterapia y el trasplante de células hematopoyéticas. Los factores de riesgo cardiovascular son prevalentes en los supervivientes de cáncer. Estos pacientes deberían ser considerados en alto riesgo cardiovascular. Se aconseja recomendar hábitos de vida saludables y un control estricto de los factores de riesgo. Hay una necesidad inmediata para ampliar la disponibilidad de servicios preventivos cardiovasculares de cara a reducir los efectos adversos tardíos de la quimioterapia y la radiación. La intervención precoz podría ayudar a mejorar el perfil de riesgo cardiovascular. (AU)
Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile (AU)
Subject(s)
Humans , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Antineoplastic Agents , Neoplasms/complications , Neoplasms/epidemiology , Prevalence , Risk FactorsABSTRACT
La mayor disponibilidad de nuevos tratamientos oncológicos en los últimos años ha conllevado una mejoría del pronóstico e incremento de la expectativa de vida de los pacientes con cáncer, si bien a expensas de un incremento del riesgo cardiovascular. Por este motivo ha surgido la necesidad de la creación de equipos multidisciplinares para la valoración conjunta de estos pacientes y así lograr optimizar la salud cardiovascular y la supervivencia global de estos pacientes, minimizando las interrupciones de los tratamientos onco-hematológicos. Existe un amplio abanico de toxicidades cardiovasculares asociadas a los diferentes tratamientos del cáncer. El control estructurado del riesgo cardiovascular antes, durante y después del tratamiento oncológico permite seguir estrategias de prevención, detección temprana y tratamiento precoz de las cardiotoxicidades. (AU)
The increased availability of new cancer treatments in recent years has led to improved prognosis and increased life expectancy for cancer patients, but at the expense of increased cardiovascular risk. For this reason, multidisciplinary teams need to be formed for the joint evaluation of these patients to optimise the cardiovascular health and overall survival of these patients and minimise interruptions to onco-haematological treatments. A wide range of cardiovascular toxicities are associated with the various cancer treatments. The structured control of cardiovascular risk before, during and after oncological treatment will enable strategies for the prevention, early detection and early treatment of cardiotoxicities. (AU)
Subject(s)
Humans , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Neoplasms/complications , Neoplasms/therapy , Cardiotoxicity/etiology , PrognosisABSTRACT
Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile.
Subject(s)
Antineoplastic Agents , Cardiovascular Diseases , Neoplasms , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Heart Disease Risk Factors , Humans , Neoplasms/complications , Neoplasms/epidemiology , Risk FactorsABSTRACT
The increased availability of new cancer treatments in recent years has led to improved prognosis and increased life expectancy for cancer patients, but at the expense of increased cardiovascular risk. For this reason, multidisciplinary teams need to be formed for the joint evaluation of these patients to optimise the cardiovascular health and overall survival of these patients and minimise interruptions to onco-haematological treatments. A wide range of cardiovascular toxicities are associated with the various cancer treatments. The structured control of cardiovascular risk before, during and after oncological treatment will enable strategies for the prevention, early detection and early treatment of cardiotoxicities.
Subject(s)
Cardiovascular Diseases , Neoplasms , Cardiotoxicity/etiology , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Humans , Neoplasms/complications , Neoplasms/therapy , PrognosisABSTRACT
This section focuses on different aspects of the individualization of hormone treatment in breast cancer. This includes tumor-related biological factors such as expression of hormone receptors, HER-2, and Ki-67; host-related factors such as CYP2D6 or body mass index, and risk and/or development of specific toxicities and treatment adherence. The best predictor of response to hormonal interventions is the expression of hormone receptors, in particular, estrogen receptors. Treatment adherence and compliance are key factors and strategies aiming to identify and intervene when patients are at risk of abandoning treatment. Currently, routine assessment of CYP2D6 is not recommended to guide tamoxifen treatment. Likewise, there are no criteria regarding bone mass density, lipid profile, or arthralgias to recommend one class of agent versus another. Aromatase inhibitors should not be administered to patients who are pre- or perimenopausal.
