Cardio-Oncology

Overview

A cardio-oncologist is a cardiologist with additional expertise in caring for patients with cancer. The focus is not on treating the cancer itself, but on protecting and managing heart health in people undergoing cancer therapy — both during active treatment and in the years that follow.

What this involves

Cardio-oncology care spans the full arc of a patient's cancer journey. This includes assessing heart health before treatment begins, monitoring for changes while therapy is under way, managing any cardiovascular complications that arise, and providing long-term follow-up once treatment has concluded.

Balancing two priorities

A central part of this role is holding two priorities in balance: ensuring that cancer treatment can be delivered as effectively as possible, while minimising any risk to the heart. This requires close collaboration with your oncologist and the broader treating team, with all decisions made with your overall wellbeing in mind.

Overview

Cancer treatments have improved substantially, and far more people are now living long lives after a cancer diagnosis. As survival rates improve, the long-term effects of treatment — including their impact on the heart and circulation — have become increasingly important to recognise and manage.

Who is affected

Cardiovascular complications do not affect everyone undergoing cancer treatment, but they are more likely in certain groups. Some patients have pre-existing heart disease or cardiovascular risk factors that make them more vulnerable to treatment-related effects. Others develop heart problems during treatment, while some experience delayed effects that may not become apparent until years after therapy has ended.

Goals of care

The aim of cardio-oncology is to identify patients at higher risk before problems occur, detect any changes early when they are most manageable, reduce the overall impact of cancer treatment on heart health, and support long-term cardiovascular wellbeing so that the benefits of cancer therapy are not undermined by preventable heart complications.

Overview

Not all patients with cancer require a cardio-oncology review, but it is particularly valuable in certain clinical situations. Referral is typically guided by the type of cancer therapy planned, the presence of pre-existing cardiovascular conditions, and any symptoms that develop during or after treatment.

Common reasons for referral

You may be referred to cardio-oncology if you have pre-existing heart disease or cardiovascular risk factors such as hypertension or diabetes, if you are about to commence a cancer therapy known to affect the heart, if you develop new cardiac symptoms during treatment, or if you have previously received cancer therapy and are now experiencing heart-related problems.

Timing of care

Cardio-oncology involvement can occur at any point in the treatment journey. A baseline assessment before commencing therapy allows us to establish your cardiovascular starting point and identify any issues that should be addressed in advance. Monitoring during treatment enables early detection of changes. Long-term follow-up after treatment is complete is important for patients known to be at risk of delayed cardiovascular effects.

Overview

Cancer therapies can affect the heart and circulation in a number of different ways. The nature and timing of these effects depend on the treatment used, the doses given, and an individual's underlying cardiovascular health. In most cases, complications are manageable when identified early — which is precisely why monitoring and proactive assessment are so important.

Conditions commonly assessed and managed

Cardio-oncologists are trained to recognise and manage the full range of treatment-related cardiovascular problems. The most common include reduced heart muscle function (cardiomyopathy and heart failure), disturbances of heart rhythm (arrhythmias), elevated blood pressure, coronary artery disease, and blood clots or vascular complications. These conditions may arise during active treatment or present months to years afterward, depending on the therapy involved.

Overview

Understanding which cancer therapies are associated with specific cardiovascular effects allows us to direct monitoring toward the patients most likely to benefit. The following are the most commonly encountered examples in clinical practice.

Therapy-specific effects

Overview

A range of cardiac tests are used in cardio-oncology to establish baseline heart function, detect early changes during treatment, and monitor recovery or progression over time. The tests recommended for each patient are selected based on the type of cancer therapy, the level of cardiovascular risk, and any symptoms present.

Commonly used tests

Echocardiography — including advanced strain imaging — is the most frequently used tool, as it allows detailed, non-invasive assessment of heart muscle function and valve health without radiation. An electrocardiogram (ECG) records the electrical activity of the heart and is used to detect rhythm disturbances. Blood tests measuring cardiac biomarkers such as troponin can provide early warning of heart muscle stress. In selected cases where greater detail is required, cardiac MRI may be arranged — further information on this test is available in our Advanced Cardiac Imaging patient information sheet.

Purpose of monitoring

The goal of cardiac monitoring is not simply to detect problems, but to detect them early enough to act. When changes in heart function are identified at an early stage, there is far greater scope to adjust treatment, introduce protective medications, or implement lifestyle measures — often allowing cancer therapy to continue safely while cardiovascular risk is managed in parallel.

Overview

Cardio-oncology care does not operate in isolation. It is delivered in close collaboration with your oncologist, haematologist, radiation oncologist, and any other specialists involved in your care. Shared decision-making — informed by both cardiovascular and oncological expertise — is central to providing care that is safe, coordinated, and tailored to your individual situation.

Our role within your team

Our role is to contribute cardiovascular expertise to your overall care plan. This may involve advising on the safety of proceeding with planned cancer therapy, recommending cardiac treatment or protective medications, providing monitoring at agreed intervals, or offering a specialist opinion at key decision points in your treatment journey. Cardio-oncology input complements, but does not replace, the care provided by your treating oncologist and other clinicians.

Your involvement

We encourage patients to be active participants in their care. If you develop new symptoms — such as breathlessness, palpitations, chest discomfort, or ankle swelling — at any point during or after cancer treatment, please let your treating team know promptly. Early reporting of symptoms allows problems to be assessed and addressed before they become more complex.