Our cardio-oncology teams support the overall care of cancer patients with cardiovascular disease, before, during or after their treatment. You could benefit from their expertise if you:

Need to start cancer treatment and have a pre-existing heart condition or one or more heart disease risk factors, such as high blood pressure, diabetes, obesity or high cholesterol

Develop heart disease symptoms including fatigue, shortness of breath, chest pain or palpitations (arrhythmia) while undergoing cancer treatments such as chemotherapy, immunotherapy or radiotherapy

Develop heart problems after undergoing cancer treatment in the past, such as in childhood

Have a heart tumour, a rare but serious condition that we have experience with

While relatively uncommon, heart problems can potentially affect anyone who has cancer treatment. The risk is higher in those with pre-existing heart disease and in those with poorly controlled risk factors like high blood pressure. 

Whether you're due to receive cancer treatment, are currently undergoing it or have completed it recently or many years ago, our specialists can help. We offer same- and next-day private GP appointments. If you already have a referral, you can request a consultant appointment directly and have it confirmed within 24 hours.   

What cancer treatments can contribute to heart problems?

Heart damage may arise during or after receiving cancer treatment. Certain types of treatments have a higher risk for cardiotoxicity, and there are usually ways to prevent or manage such side effects. The risk can be higher if you're receiving larger doses or multiple treatment types. 

Cancer treatments which may cause cardiotoxicity include:

• Chemotherapy, including a type called anthracycline. Chemotherapy heart damage can be more likely if you're taking multiple chemotherapy drugs together or combining it with the treatments below.
• Immunotherapy treatments are newer targeted cancer treatments. While they can be more effective in some cases than traditional chemotherapy, a number of them have potential cardiac side effects and can for example lead to myocarditis (inflammation of the heart muscle), high blood pressure and heart failure.
• Radiation therapy to the chest. Cardiac issues (inflammation of the heart and valve disease) can occur acutely at the time of treatment or as a late effect many years after completing radiotherapy.  

When receiving cancer care from us, your heart oncologist will provide a recommended plan that balances the need to treat your cancer with the need to protect your heart. 

How is cardiotoxicity diagnosed? 

If you experience heart problems during or after cancer treatment, your doctor may perform a range of tests to identify the underlying problem and cause. Your doctor may still check for heart problems if you're asymptomatic but have a higher risk, e.g. if you're receiving certain treatments, are aged over 60, or received cancer treatment as a young child. 

You may be referred to a cardiologist depending on the results or types of tests needed. As well as a physical examination to listen to your heartbeat, tests to diagnose cardiotoxicity may include one or more of the following:

• Echocardiogram: This is an ultrasound scan of the heart looking at both function and structure. It can also assess the heart valves. 
• Cardiac magnetic resource imaging (MRI): This scan also creates detailed images of your heart, including its chambers, muscles and valves, to assess its function and structure. This test provides detailed information on the structure of the heart muscle itself.
• Cardiac CT scan: A CT scan of the heart arteries that looks for coronary artery disease (build-up of cholesterol in the arteries). 
• Cardiac stress test: This test measures how your heart responds to intense activity, usually as you walk on a treadmill at a controlled speed and incline. This test can also be performed as part of an echocardiogram or cardiac MRI investigation. 

The tests you undergo will depend on your condition. Your consultant will explain your tests in detail, including preparation if needed, and next steps based on potential results. 

What cardiotoxicity treatments are there? 

If you have a pre-existing heart condition and are due to start cancer treatment, your consultant will assess options for effectively treating your cancer while minimising the risk of further symptoms or heart damage. 

If you develop heart problems due to cancer treatment, you may be recommended steps to manage symptoms or reduce risk, such as:

• Switching to another cancer drug that's still effective in treating your cancer, but less likely to cause heart problems
• Reducing your dose of certain cancer drugs or taking them through different methods
• Reducing radiation therapy to the heart, whether by reducing the dose or administering it differently, for example, using a beam with varying intensity 

Depending on your condition, you may also be given medication to help your heart work more effectively whether during or after cancer treatment. These include:

• ACE inhibitors, which widen your arteries to improve blood flow
• Beta blockers, which increase blood flow and slow your heart rate
• Digoxin, which slows your heart rate and helps your heart beat more efficiently
• Diuretics, which help reduce fluid build-up
• Vasodilators, which open your blood vessels to help blood flow more efficiently