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Cardio-Oncology

Cardio-Oncology is a new field that is focused on preventing and/or treating patients with cancer who develop heart conditions caused by cancer treatments. Also, as new cancer treatments help patients live longer, these survivors are at risk for long term side effects of treatment that damage the heart and for heart disease.

The CardiaOncology Program at Queen’s University, KHSC (CardoOncQ) was established in 2015 by a multidisciplinary team consisting of cardiologist, Dr. Raveen S. Pal and medical oncologist, Dr. Mihaela Mates. This program now encompasses the fields of Radiation Oncology, Surgical Oncology, Pharmacy, and Diagnostic Imaging.

This program has three broad mandates: Clinical Service, Research, and Education.

 

For more information on the Cardiac Oncology Program at Queen’s/KHSC (CardoOncQ) please contact Dr. Raveen S. Pal, Cardiologist, at raveen.pal@kingstonHSC.on.ca

The Cardio-Oncology Clinic, run by Dr. R.S. Pal, provides rapid access to cancer patients who are at risk of or have experienced cardiac toxicities from their cancer therapy. The clinic provides assessment and treatment to patients diagnosed with Herceptin mediated Cardiomyopathy, 5-FU related Vasospasm and Immune checkpoint related Myocarditis. This subspecialty clinic occurs weekly and to date over 500 patients have been evaluated.

Clinical Innovations. 

  • The CardoOncQ program has established advanced care protocols for the assessment and diagnosis of cardiomyopathy. Patients are routinely monitored with advanced imaging techniques using 3 dimensional echocardiography, strain echo imaging and Cardiac MRI imaging.
  • The longterm effects of systemic and targeted treatments on the heart are not well understood. As a result initiative are underway to develop long-term survivorship cohorts. 

The goals of the research program are to expand existing knowledge of Cardiac toxicities, optimal imaging protocols and to establish a local node for participation in National cardio-oncology patient registries and research programs. CardoOncQ is engaged in the development of evidenced based guidelines for diagnosis and treatment of cardiac toxicity in cancer patients.

The CardoOncQ program is engaged in multiple Local and National research initiatives including:

  • RADICAL PC trial - a prospective cohort study of men with a new diagnosis of prostate cancer. RADICAL PC2 is a randomized, controlled trial of a systematic approach to modifying cardiovascular and lifestyle risk factors in men with a new diagnosis of prostate cancer. Trial PI is Dr. Darryl Leung at McMaster HSC.
  • 3D Echo for Improved monitoring – local prospective cohort study evaluating the additional value of 3D imaging in the monitoring of patients at risk for Herceptin mediated cardiomyopathy.
  • CV risk factors in patients undergoing Cancer treatment.

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, dedicated teaching sessions and case rounds discussions. We have also established a quarterly multidisciplinary cardiac oncology rounds to foster education of our staff, residents and fellows.

There is currently no accredited fellowship for health professionals who have special skill in managing these cardio-oncology problems, but efforts are underway to create a certified training program for the field.

Practitioners from CardoOncQ regularly participate in National and International programs including the Canadian Cardiac Oncology Network Meeting, now a Global Summit, https://cardiaconcology.ca/ and The Memorial Sloan Kettering Symposium https://mskcc.cloud-cme.com/default.aspx?P=0&EID=16222.