Cancer and the heart are becoming common terminology in both oncology and cardiology practices. With the evolution of systemic and targeted therapies in cancer treatment, it has become increasingly evident that damage to the heart may occur as a result of cancer treatment. Although cardiac toxicities associated with conventional chemotherapy are well known, the short- and long-term effects of targeted agents on the heart are less well understood.
The Cardiac Oncology Program was established at The Ottawa Hospital in 2008 by a multidisciplinary team consisting of a medical oncologist (Dr. Susan Dent), three cardiologists (Dr. Michele Turek, Dr. Christopher Johnson, Dr. Angeline Law) and a pharmacist (Sean Hopkins). This program encompasses three mandates: Clinical Service, Research, and Education. The aim of the clinical component of the program is the rapid assessment of cancer patients who are at risk of or have experienced cardiac toxicities from their cancer therapy. The goal of the research component of the program is to develop a National cardiac oncology patient registry in order to facilitate the development of evidenced based guidelines for diagnosis and treatment of cardiac toxicity in cancer patients. In collaborating with basic scientists, we are in the process of establishing a translational research program that will evaluate the role of ‘novel’ biomarkers in predicting early signs of cardiac toxicity. The goal of the educational component of the program is to educate patients, practitioners, and health care professionals at various stages of training. The educational needs of trainees are currently met through clinical rotations supplemented by self directed learning activities and future efforts will focus on producing electronic learning resources. We have established bimonthly multidisciplinary cardiac oncology rounds to foster education of our staff, residents and fellows. Future education activities will focus on web based information about the interactions between cancer therapies and the heart.
The Cardiac Oncology Program has made great strides since its inception. In October of 2008 the first multidisciplinary cardiac oncology clinic in Canada was established at The Ottawa Hospital .While the initial focus of this clinic pertained to women with early stage breast cancer exposed to chemotherapy +/- trastuzumab, the widespread adoption of targeted therapies in oncology has subsequently led to the referral of a much broader patient population. The clinic takes place three half days per months and to date over 450 patients have been evaluated. The clinic has gained recognition from several academic institutions across North America. This has led to the development of a 1-day preceptorship in Ottawa for health care professionals to facilitate the establishment of a cardiac oncology clinic in their respective centers. The cardiac oncology team is honoured to welcome Dr. Ellamae Stadnick, a cardiologist who has joined our team in 2012. Dr. Stadnick trained at Stanford and in Vancouver and brings expertise in imaging and heart failure to the cardiac oncology clinic.
In 2011, we established the Canadian Cardiac Oncology Network to bring together health care professionals interested in understanding how cancer therapies impact cardiac health. The Canadian Cardiac Oncology Network’s vision is to optimize cardiac care for cancer patients receiving potentially cardiotoxic therapies. The Network’s missions are to: 1) gain a better understanding of cardiac complications of oncology treatments, 2) develop early detection and intervention strategies to optimize cardiac health, and 3) optimize patient outcomes by collaborating with allied healthcare professionals. To date, we have hosted two Canadian Cardiac Oncology Network conferences in Ottawa, with a growing interest from a number of health care providers including: oncologists, cardiologists, nurses, pharmacists, radiologists and basic scientists. The 3rd Annual Canadian Cardiac Oncology Network Conference will be held on June 20th-21st, 2013 at The Ottawa Convention Centre.
The Cardiac Oncology Program has also established the first Cardiac Oncology Research Fellowship at the University of Ottawa to commence in July 2013. This research fellowship is designed to provide trainees with the opportunity to increase their knowledge and expertise in the detection and treatment of cardiac complications related to systemic therapy (including chemotherapy and targeted agents). The program objectives include: 1) the development of an educational pathway to increase ‘health care provider’ awareness and understanding of the cardiac complications of cancer therapies; 2) the development of quality indicators for the assessment of the Cardiac Oncology Clinic; and 3) designing and implementing a pilot study to assess novel cardiac biomarkers to detect early cardiotoxicity in cancer patients exposed to cardiotoxic agents. We are excited to announce that Dr. Jeffrey Sulpher, medical oncology resident, has been accepted as our first Cardiac Oncology Research Fellow and will commence his fellowship training in July 2013.
For more information on the Cardiac Oncology Research Fellowship please visit the following link: http://www.med.uottawa.ca/MedicalOncology/eng/postgraduate_fellowship.html
For more information on the Cardiac Oncology Program please contact Dr. Susan Dent, Medical Oncologist, at sdent@toh.on.ca.
Source: Department of Medicine
