Heart disease after chemotherapy and radiation therapy
Cancer survival has improved over the years due to newer and better forms of treatment with chemotherapy and radiation. When treating cancer, some of the treatments may cause lasting damage to your heart. This is especially true if you are at risk for heart disease.
The goal of Cleveland Clinic’s Cardio-Oncology Center is to help you complete your cancer treatment without developing such damage. We use state-of-the-art technology to identify and immediately treat the toxicity. Our care does not change or interrupt your cancer therapy.
Our team includes specialists from the Sydell and Arnold Miller Family Heart & Vascular Institute (including cardiac imaging, heart failure, electrophysiology and cardiac surgery) and the Taussig Cancer Institute. The team works together to provide expertise in diagnostic testing, medical management, and interventional and surgical procedures for patients.
This multidisciplinary team of doctors, nurses and healthcare professionals is dedicated to caring for patients in every stage of cancer treatment who are at risk for, develop or have established cardiovascular disease.
- Negishi K, Negishi T, Agler DA, Plana JC, Marwick TH. Role of Temporal Resolution in Selection of the Appropriate Strain Technique for Evaluation of Subclinical Myocardial Dysfunction. Echocardiography. 2011 Dec 9. doi: 10.1111/j.1540-8175.2011.01586.x. [Epub ahead of print]
- Daher IN, Kim C, Saleh RR, Plana JC, Yusuf SW, Banchs J. Prevalence of abnormal echocardiographic findings in cancer patients: a retrospective evaluation of echocardiography for identifying cardiac abnormalities in cancer patients. Echocardiography. 2011 Nov;28(10):1061-7.
- Sawaya H, Plana JC, Scherrer-Crosbie M. Newest echocardiographic techniques for the detection of cardiotoxicity and heart failure during chemotherapy. Heart Fail Clin. 2011 Jul;7(3):313-21. Review.
- Sawaya H, Sebag IA, Plana JC, Januzzi JL, Ky B, Cohen V, Gosavi S, Carver JR, Wiegers SE, Martin RP, Picard MH, Gerszten RE, Halpern EF, Passeri J, Kuter I, Scherrer-Crosbie M. Early detection and prediction of cardiotoxicity in chemotherapy-treated patients. Am J Cardiol. 2011 May 1;107(9):1375-80. Epub 2011 Mar 2.
- Banchs J, Jefferies JL, Plana JC, Hundley WG. Imaging for cardiotoxicity in cancer patients. Tex Heart Inst J. 2011;38(3):268-9.
- Hare JL, Brown JK, Leano R, Jenkins C, Woodward N, Marwick TH. Use of myocardial deformation imaging to detect preclinical myocardial dysfunction before conventional measures in patients undergoing breast cancer treatment with trastuzumab. Am Heart J. 2009 Aug;158(2):294-301.
- Albini A, Pennesi G, Donatelli F, Cammarota R, De Flora S, Noonan DM. Cardiotoxicity of anticancer drugs: the need for cardio-oncology and cardio-oncological prevention. J Natl Cancer Inst. 2010 Jan 6;102(1):14-25. Epub 2009 Dec 10.
The Cardio-Oncology Center provides care to patients in varying stages of cancer treatment who have or are at risk for heart disease. Our range of services includes evaluation and treatment of patients:
- Who will begin cancer treatment and have risk factors for heart disease
- Who will begin cancer treatment and are being treated for heart disease
- Who are undergoing chemotherapy or radiation and develop symptoms of weakness or fatigue;
swelling of the legs and feet; chest pain; irregular heart beats; and/or dizziness
- Who have had cancer treatment in the past and develop new cardiac problems
- Who have had radiation therapy in the past and need surgical or interventional treatments
- Who have developed advanced heart failure due to previous cancer treatment and need advanced treatment, such as a heart pump or heart transplant
- Who have a cardiac tumor
Our team of healthcare professionals offer patients:
- A full range of imaging techniques and diagnostic studies. These allow for early detection of heart and blood vessel damage and arrhythmias. These tools include cardiovascular exam, electrocardiogram (ECG), and state-of-the-art echocardiography, including 3D, contrast and strain imaging.
- Collaborative medical management. Our cardiologists and oncologists will discuss your test results. Together, we will design the best cancer treatment plan for you. This includes the choice of treatment, dosage and schedule.
- Ongoing follow-up care during cancer treatment. This lets us find and treat heart and vascular changes early in your care and work to create the best long-term outcomes possible.
- Continued care after cancer treatment. You can develop heart damage (cardiotoxicity) within the first year after therapy, and even several years after therapy. We provide follow-up care and early treatment, if needed.
- Advanced surgical options for patients with valve and pericardial disease caused by previous radiation therapy.
- Advanced heart failure therapies, such as specialized medical treatment, artificial heart pumps and heart transplantation, for patients with end-stage heart failure caused by chemotherapy or radiation.
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.
Leaders in the field from America’s top ranked Heart Program and one of America’s top Cancer Programs are working together to offer you the best diagnostics and treatment possible.
Cleveland Clinic's Section of Cardiovascular Imaging pioneered the clinical use of strain imaging. This is an innovative technique that allows early detection of cardiotoxicity. This helps determine the best plan for cancer treatment and predict the amount of heart damage it will cause.
Cleveland Clinic's Cardio-Oncology Center staff includes a multidisciplinary group of expert healthcare professionals from the Miller Family Heart & Vascular Institute and Taussig Cancer Institute. This collaboration is designed to provide you with the best possible care of your heart before, during and after cancer treatment.
Our Medical Team
G. Thomas Budd, MD
Co-Director, Cardio-Oncology Center, Solid Tumor Oncology (Breast and Sarcomas)
Sydell and Arnold Miller Family Heart & Vascular Institute: Cardiovascular Medicine
- Juan Carlos Plana, MD - Co-Director, Cardio-Oncology Center
- Brian Griffin, MD - Cardiovascular Imaging
- Scott Flamm, MD - Section Head, Diagnostic Radiology
- Balaji Tamarappoo, MD, PhD - Cardiovascular Imaging
- Milind Desai, MD - Cardiovascular Imaging, special interest radiation heart disease
- Karen James, MD - Heart Failure and Transplantation
- W.H. Wilson Tang, MD - Heart Failure and Transplantation
- David Taylor, MD - Heart Failure and Transplantation
Physician Assistant and Program Coordinator
Taussig Cancer Institute
- G. Thomas Budd, MD – Co-Director, Cardio-Oncology Center, Solid Tumor Oncology (Breast and Sarcomas)
- Halle Moore, MD - Oncologist (Breast Cancer)
- Roger Macklis, MD - Radiation Oncology
- Rahul Tendulkar, MD - Radiation Oncology
- Brad Pohlman, MD – Hematologic Oncology and Blood Disorders (Lymphoma)
- Mikkael Sekeres, MD, MS – Hematologic Oncology and Blood Disorders (Leukemia)
- Brian Rini, MD – Solid Tumor Oncology (Renal Cell Carcinoma)
- Steven Andresen, DO – Solid Tumor Oncology; Hematologic Oncology and Blood Disorders (Breast Cancer)
Thoracic and Cardiovascular Surgery
What to Expect
Whether you are coming from around the corner or around the world, you want to know what to expect before, during and after your visit with us. If you have any questions while reviewing this information, please contact us. We are happy to answer any questions you may have.
To start the process, contact the Heart and Vascular Institute Resource Nurse by phone, email or chat online. She will ask you a few questions to gather information about your cancer and heart history. She will forward this information to the Cardio-Oncology nurse, who will contact you with the next steps for your evaluation.
- »Before Your Appointment
If your appointment is at least one week away, please send us your records. Please include your medical history, previous or current cancer diagnosis, chemo and/or radiotherapy regimen received, list of medications, test results and films (echocardiogram, ultrasound, chest x-ray, MRI, CT, etc.). All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number). Send your records to:
c/o Dr. Juan Carolos Plana
Cardio-Oncology Center – Desk J1 - 5
9500 Euclid Avenue
Cleveland, OH 44195
If your appointment is less than a week away, please bring your records to your appointment.
Traveling to Cleveland Clinic
We want your trip to Cleveland Clinic to be as easy as possible. Information on traveling to the Miller Family Heart & Vascular Institute.
Please note: Parking for your appointment will vary whether you are at Taussig or the Miller Family Heart & Vascular Institute.
Please contact the Cardio-Oncology Center office, care of Dr. Plana-
216.444.5910 (or call the physician’s office directly).
- »During Your Appointment
- First, you will meet with either a nurse clinician or fellow who will review your information and begin the documentation process. This may involve:
- Thorough history and physical examination
- Strain Imaging Testing
Next, you’ll meet with your Center physician who will review your records and take a medical history and perform a physical exam. You may see other specialists within the Center. You will get results from your visit the same day. We will also provide you with a diagnosis and plan of care for your oncologist.
How long will you need to stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area for 1 to 2 days.
- »After Your Visit
Your doctor will let you know when to come back for another visit.
Locally 216.445.9288 or toll-free 866.289.6911 to speak to a Heart & Vascular Nurse
When you make your appointment, ask the administrative assistant for the name of your physician and desk number. You will be told to go to Desk J2 - 4 or Desk M41, 9500 Euclid Avenue, Cleveland, OH.
Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.
Mon. - Fri., 8 a.m. - 5 p.m. (ET):
locally 216.445.7430 or toll-free 800.223.2273, ext. 57430
At all other times call Patient Access Services locally 216.444.8302 or toll-free 800.553.5056.
Cleveland Clinic Heart and Vascular Institute physicians, surgeons, and researchers continue to research into new treatments and therapies with the goal of improving patient care and outcomes into the future.
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