Dados do Trabalho

Título

IMPLEMENTATION OF A CARDIO-ONCOLOGY SERVICE IN A PRIVATE HOSPITAL IN RIO DE JANEIRO

Introdução

Cardiovascular disease (CVD) is increasing among cancer patients/survivors. Cancer and CVD share risk factors, including smoking, diabetes, obesity, hypertension, physical inactivity and genetics. They also share common pathophysiological mechanisms such as inflammation. Cardio-oncology is an emerging subspecialty that collaborates in the comprehensive care of patients with cancer and CVD, two leading causes of death.

Objetivo

To establish a multidisciplinary approach by CVD specialists in order to assess risk stratification for chemotherapy treatment, ensure that it continues safely and without interruptions, and monitor these patients after the end of anticancer therapy.

Método

The assessment of all onco-hematological patients under treatment in the hospital was scheduled, including mainly those initially identified with risk factors such as comorbidities (heart failure, arrhythmia, coronary heart disease, valve disease and pulmonary thromboembolism), class of drugs (beta blocker, ACE inhibitors and ARBs, spironolactone, digitalis, clopidogrel and amiodarone/propafenone), specific cancer drugs (anthracyclines, alkylating agents, antimetabolites, taxanes, tyrosine kinase inhibitors, VEGF inhibitors, BRAF and MEK inhibitors) and pre-procedures (surgical risk assessment, type of surgery and bone marrow transplant). Multidisciplinary approach and care of these patients are essential for rapid risk identification and prompt activation of the cardio-oncology team, using the electronic medical record as a communication tool. Other activities of the cardio-oncology service include participation in a weekly multidisciplinary discussion, availability of at least one cardiologist in attendance during the week (morning and afternoon) and elaboration of an institutional clinical session.

Resultado

The group began its activities with a pilot program in the onco-hematology ward in February 2021. As this is a new service in the hospital and also a new concept of multidisciplinary approach for cancer patients, we carried out wide dissemination among the teams: clinical, onco-hematology and multiprofessional. There were 16 evaluations (9 men and 7 women).

Conclusão

Cardio-oncology services can benefit patients at all stages of the cancer care line, from diagnosis confirmation to years after the end of cancer therapy. Benefits include a specialized clinical assessment for CVD prevention, maintenance of quality of life, educational aspects and development of research in this area.

Palavras-chave

oncology, cardiology,
multidisciplinarity