ABSTRACT
Modern cancer treatments have led to significant improvements in clinical outcomes for patients, but may be associated with a wide range of toxicities, including cardiotoxicity. Cancer therapy-related cardiovascular dysfunction may not only have an impact on quality of life, but may increase mortality. Hence, cardioprotective strategies play an important role in the treatment of cancer patients. The main goal of preventative strategies is to reduce the cardiac side effects of cancer therapies, leading to a safer and more effective cancer treatment.
Lifestyle recommendations and pharmacological agents are the most discussed cardioprotective measures, although most trials in this field have evaluated small samples with different cardiac imaging-based endpoints. The strengths and limitations of these trials will be addressed in this chapter, as well as the important role of exercise in all phases of cancer treatment. Survivorship programs will also be discussed, as evidence in this field is growing, leading to recommendations by main international societies.
Although there is a paucity of robust evidence evaluating cardioprotective strategies, clinical decision making at the bedside should be guided by the best evidence available. Ultimately, prevention programs are designed to favor the maintenance of the best oncological treatment while respecting cardiovascular safety. Multidisciplinary teams and close collaboration between cardiologists and oncologists are the key for success in this field.
