Cardio-Oncology Collaboration Could Reduce Cardiovascular, Breast Cancer Risks: Eric H. Yang, MD

Eric H. Yang, MD, of the University of California, Los Angeles, told The American Journal of Managed Care at the San Antonio Breast Cancer Symposium that breast cancer and cardiovascular disease share many risk factors and require closer collaboration between oncology and cardiology to develop interventions that lower the risk of both conditions.

Yang said current cardioprotection practices for patients receiving anthracyclines should include baseline and follow-up echocardiography to detect declines in ejection fraction early. He warned that some patients can remain asymptomatic for months or years despite abnormal ejection fraction, risking progression to irreversible heart failure. For HER2-targeted therapies, he noted the absolute incidence of cardiotoxicity is low and questioned whether the frequent imaging protocols used when anthracyclines are not part of the regimen are always necessary.

On immunotherapy, Yang described ongoing debate about the value of routine biomarker checks before or during treatment. He emphasized the importance of integrated care teams that can detect and manage immune-related toxicities affecting the heart, endocrine system, liver and gut, since overlapping syndromes can be severe or fatal if not identified early.

Yang highlighted lifestyle interventions as a promising area for joint cancer and cardiovascular prevention. Age, obesity, smoking and diet contribute to both diseases, creating an opportunity to test interventions that reduce risks across endpoints rather than addressing them separately. He pointed to GLP-1 receptor agonists and other effective weight-loss medications as proven to lower the risk or severity of heart failure, but said their effects on cancer recurrence and long-term outcomes after cancer therapy remain unknown and warrant study.

Yang advocated maintaining as much normalcy as possible for patients, reversing outdated advice to avoid exercise. He said regular physical activity can improve quality of life, enhance tolerance of cancer treatment and reduce cardiovascular risk, important given rising survival rates.