Cardio-Oncology Clinical Services

The Vanderbilt Cardio-Oncology Program includes diverse clinical groups all addressing the cardiovascular health of cancer patients and cancer survivors. Specifically the Vanderbilt Cardio-Oncology Program includes:

Cardiovascular Wellness during Cancer Survivorship

A revolution has occurred in cancer treatment over the last decade. As a result, there are over 14 million cancer survivors in the United States alone. At least 3 million of these are breast cancer survivors with another almost 3 million prostate cancer survivors. Chemotherapy and radiation treatments that effectively treat cancer can also result in short-term and long-term heart and vascular disease. The Vanderbilt Cardio-Oncology program is a leader in developing strategies for cardiovascular health during survivorship. Our group has developed the ABCDE’s of cardiovascular health during survivorship. This represents specific steps that each patient can make with their physician in order to prevent hear and vessel disease during survivorship.

Cardio-MRI

ABCDE

 

A

  Awareness of risks of heart disease

 

  Aspirin

 

  Androgen Deprivation Therapy (for prostate caner)

B

  Blood Pressure

C

  Cholesterol

 

  Cigarette/Tobacco cessation

 

  Cardiac Imaging (Cardiac MR, PET scan)

D

  Diet and weight management

 

  Dose of chemotherapy or radiation

 

  Diabetes prevention/treatment

E

  Exercise

 

  Echocardiogram

Thrombosis and Blood Clots

Cancer is major and independent risk factor for blood clots in cancer patients. These are defined as venous thromboembolism (VTE). The clot may occur in the veins of the legs (Deep Vein Thrombosis or DVT) and migrate to the vessels in the lung (Pulmonary Embolism or PE).  These events are reported in up to 20% of patients with cancer. Blood clots can also occur in the arteries to the heart and lead to myocardial infarction (heart attack) or stroke. The impact of these thrombotic complications can be very serious and possibly fatal. Thrombosis (blood clot) is the second leading cause of death in patients with cancer. Patients with cancer and VTE have a shorter overall survival than cancer patients without VTE independent of the stage of treatment or type of tumor. In addition, cancer patients that sustain a VTE have an increased risk of recurrent VTE, bleeding complications, and an increased utilization of medical resources.

The Vanderbilt Cardio-Oncology group has a dedicated interest on the role of thrombosis in cancer patients. Our cardio-oncologists work closely together to provide the latest diagnostic and therapeutic tools to predict, identify, and treat cancer patients who are at risk and develop thrombotic events. Our clinicians also collaborate with research colleagues to identify the best techniques to diagnose and treat these problems. Our interests include early detection, alternative strategies for anticoagulation, advanced imaging techniques, and interventional techniques to remove and dissolve clots in the lungs.

The prevention and treatment of thrombotic events in cancer patients represent a major challenge in clinical practice. Our goal is to provide optimal, high quality, guideline driven care in a collaborative setting to patients dealing with a diagnosis of cancer. We also strive to achieve this goal so that the patient may receive the best individualized therapy with the best outcome and minimal complications.

Click for more information about the Vanderbilt Cardio-Oncology Thrombosis Center,

 

Cardio-Oncology Heart Failure/Transplant Program

The early detection and prevention of Heart Failure, a common manifestation of the cardiotoxicity of certain chemotherapies, is an area of particular strength. The advanced heart failure and transplant program is already established as major center in the country.

Both traditional chemotherapies (such as anthracyclines/Adriamycin) and newer therapies (such as trastuzumab/Herceptin) can damage the heart muscle causing the heart to pump less efficiently and over time can cause symptoms of heart failure. A major focus of the Vanderbilt Cardio-Oncology program centers around developing new strategies for early detection and prevention of heart failure. This Cardio-Oncology clinicians work closely with Vanderbilt advanced heart failure and transplant program to provide cutting edge care for patients suffering from heart failure that arises from chemotherapies In addition, there are many innovative clinical protocols in place to be proactive about protecting the heart while patients undergo the most advanced cancer treatment.  These include using cardiac biomarkers and advanced specialized imaging to detect any developing cardiac issues.  

 

Vanderbilt Amyloidosis Multidisciplinary Program (VAMP)

Vanderbilt Amyloidosis Multidisciplinary Program (VAMP) is a new comprehensive patient treatment team that is committed to providing the best available clinical care to patients who have suspected or confirmed amyloidosis. A team of providers evaluates each patient and the most advanced diagnostic and treatment strategies are carefully applied for optimal outcomes. There is a patient support group and bi-monthly multidisciplinary meetings to discuss difficult decisions, ongoing cutting edge clinical research protocols, and state of the art stem cell and solid organ transplants as part of coordinated treatment.  Efforts to be a recognized worldwide leader by raising awareness of this disease and designing clinical research studies to improve treatment options are ongoing.  A dedicated team of hematologists, cardiologists, neurologists, gastroenterologists, pulmonologists, nephrologists, pathologists and other providers all actively participate in the program.  We accept referrals from all over the southeast and carefully coordinate care with referring local physicians.   We aim to be an exemplary center for the treatment of Amyloidosis.

 

Vascular and Metabolic diseases in Cardio-Oncology

The tumor needs both new vessels to feed oxygen and nutrients as well as energy to fuel its growth. Many of the novel targeted therapies in oncology affect either the vessels or the how the cancer cells use fuel (metabolism). A new frontier in cardio-oncology represents damage to the vessels or metabolism (blood sugar, cholesterol) as a result of novel therapies. The Vanderbilt program has emerged as a leader in this new frontier in cardio-oncology. It includes a close collaboration between our clinicians and researchers to understand these novel toxicities and develop preventive and treatment strategies such that the cancer therapies can be used most effectively for patient care.