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Chemotherapy, immunotherapy and radiation do important work. They attack and kill cancer cells. But they can also be hard on healthy parts of your body — like your heart.

Especially if you already have, or are at risk for, heart disease. This damage (cardiotoxicity) can start during cancer treatment — or years later. And it can cause all kinds of heart problems. Some are reversible. Others aren’t.

And that’s where cardio-oncology comes in. Cleveland Clinic’s experienced cardio-oncology providers keep a close eye on your heart health as you move through cancer treatment and beyond. No matter where you are on your journey, we’re here for you — and your heart.

Why Choose Cleveland Clinic for Cardio-Oncology Care?

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National recognition:

Cleveland Clinic is nationally ranked for its heart care and recognized as a world leader in cardiovascular care. The International Cardio-oncology Society recently awarded our clinical staff gold status, its highest award, for ongoing patient care and research.

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Patient-centered care:

Whether you’re at risk for heart disease or already have it, our cardio-oncology team is here to care for you. We run the latest tests to look for heart damage. And we plan your heart care to match your specific needs — and cancer treatments.

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Specialized knowledge:

Our goal? To help you finish cancer treatment without heart damage. We use the latest technology to find and quickly treat cardiotoxicity — often, alongside cancer treatment — so you may not need to put your cancer care on hold.

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Innovation and research:

Cleveland Clinic’s researchers always look for new ways to improve heart and cancer care. Not just for our patients today, but also for those who come to us tomorrow. Our clinical trials let us test new drugs, surgical techniques and other treatments before they’re widely available.

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Skilled collaborative providers:

When you’re going through cancer treatment — and at risk for heart disease — we have the team you need. Experienced, caring providers from different specialties work together to plan and manage your care. You’ll see experts from cardiology, oncology, radiology, electrophysiology and more. Meet our team.

Having a Cardio-Oncology Evaluation at Cleveland Clinic

Cancer treatments keep getting better and better. And so do survival rates. But even though they’re effective at killing abnormal cells, cancer drugs (chemotherapy) and radiation therapy to your chest can sometimes cause lasting damage to your heart.

And it may not be right away. Sometimes, cardiotoxicity can show up years after you’ve had cancer treatment. It’s common in adults who had childhood cancer treatment. Or people at risk for, or who already have, heart disease

Rarely, cancer can directly invade the heart, and in such cases our team is here to help.

Reasons why you may need cardio-oncology care

When you start cancer treatment, we consider many factors as we plan your care. We’ll consider building a cardio-oncology evaluation (and treatment) into your care plan if you:

Left undetected or untreated, cardiotoxicity can also cause an enlarged heart (cardiomyopathy) or heart valve disease. It can trigger heart attacks. And it can thicken your heart’s lining (constrictive pericarditis). If you have heart risk factors or have been diagnosed with heart disease, a cardio-oncology evaluation is an important part of your cancer treatment plan.

What to expect during your evaluation

When you come to your evaluation, your provider will spend time getting to know you. Understanding your story is an important part of this process. So, they’ll ask you questions about your overall health, your family health history and if you’ve had any problems with your heart before or during cancer treatment. You’ll want to be ready to go over what kind of symptoms you’ve had and how long you’ve had them.

During the evaluation, your provider will order tests to check your risk of getting cardiotoxicity — or spot signs of it before it starts to cause serious damage. You may have tests like:

  • Echocardiogram (Echo). Checks your heartbeat and blood flow.
  • Electrocardiogram (EKG). Checks your heart rhythm and can show if you’ve had a heart attack, heart failure or heart damage.
  • Cardiac MRI. Creates detailed pictures of your heart from the inside. It lets us see how blood flows through your heart.
  • Cardiac CT scan. Uses X-rays from different angles to create a detailed picture of your heart.
  • Cardiac stress test. Helps us see how your heart reacts when it’s working hard.

We may also do cardiac blood tests to check for cardiac enzymes (cardiac biomarkers). These enzymes show up in blood samples when there’s heart damage.

Meet Our Cardio-Oncology Team

Getting care at Cleveland Clinic means you’ll have a team of expert providers from different specialties, carefully selected for your unique needs. This team works together to plan and manage your heart and cancer care for the best results. You may see:

Locations

Our healthcare providers see patients at the following locations in Northeast Ohio.

Getting Cardio-Oncology Care at Cleveland Clinic

Your care team will go over your test results with you. And they’ll talk with you about your treatment options, always keeping your cancer care plan in mind. They’ll go over the risks and benefits of both cancer and heart treatment. And they’ll explain how we can try to move cancer treatment along — while addressing heart risks and problems.

We keep all of this in mind as we build your cardio-oncology care plan to focus on limiting heart damage while treating cancer. You may have:

Medications

If you’re taking any medications that could affect your heart, our team may recommend stopping them. Or they may decrease the dose or find an alternative.

They may also recommend drugs to help your heart work better, like:

  • ACE inhibitors open blocked arteries so blood flows better.
  • Beta-blockers increase blood flow and slow a rapid heart rate.
  • Guideline-directed medical therapy (GDMT) uses four different drugs to treat you, especially if your heart isn’t pumping enough blood from its left ventricle (heart failure with reduced ejection fraction).

Our team works together (and with you) to choose the right drugs, dosage and how often you should take them.

Surgery

For a very small minority of patients that have advanced heart failure or damage from earlier cancer treatments, we may recommend heart surgery. This could include artificial heart pumps, valve repair or replacement, or even a heart transplant. Our team will go over everything you need to know about surgery before it ever happens.

Life after cancer treatment

Even after your cancer treatment ends, we keep a close eye on you. Even if you didn’t have heart problems during treatment. Why? Because cardiotoxicity can develop even several years after chemo or radiation therapy. Regular testing and follow-up visits help us catch any changes in your heart and start treatment as soon as possible.

Taking the Next Step

You have a lot on your mind when you go through cancer treatment. So, when you find out these treatments may be causing problems with your heart, it may feel a little unsettling. We make sure you understand what’s going on and how your heart care will coexist with your cancer treatment. And if you know you’re at risk before you start treatment, we’re here to help you avoid damage as much as we can. You can count on our expert cardio-oncology team to be there for you — before, during and after cancer treatment.

Getting an appointment with Cleveland Clinic’s cardio-oncology experts is easy. We’re here to help you get the care you need.

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Getting an appointment with Cleveland Clinic’s cardio-oncology experts is easy. We’re here to help you get the care you need.


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Survivorship

Learning you have cancer can be stressful, shocking and challenging. From the moment you get the news, you're a survivor. As you face the challenges that go along with cancer treatment and recovery — physical and emotional — we’ll be right there with you.

At Cleveland Clinic, survivorship care is one part of your journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your cancer diagnosis. Lending a helping hand along the way, we want you to not only survive, but thrive on this journey and beyond.

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