This book is designed for clinical cardiologists and other physicians working with cardiac
patients where specific specialized teams of cardio-oncologists are not available and who are
called to perform a clinical consultation to evaluate both the cardiac condition and the
eligibility for chemotherapy or radiotherapy treatment and to evaluate if a cancer treatment
produces toxic effects on a patient treated with chemo or radiotherapy and if appearance of new
symptoms is due to this treatment. In recent years progress in oncologic therapy has resulted
in important developments and the prognostic improvement of patients with malignancy. The
cornerstone of chemotherapy are the anthracyclines (and the analogue Mitoxantrone) that are
direct cellular toxic agents and that are among the most powerful anti-neoplastic drugs but
their cardiac toxicity is well known. Significant breakthroughs in cancer therapy have also
been achieved with the introduction of signalling inhibitors such as VEGF inhibitors HERB2
inhibitors or TK inhibitors used alone or in combination with direct cellular toxic drugs.
However these signalling inhibitors may interact also with cardiovascular signalling and
therefore may have functional or structural effects on the myocardium. This can be permanent or
reversible with impairment of the global conditions and important side effects and increase
both morbidity and mortality and worsening of quality of life. Chemotherapy and radiotherapy
can have acute detrimental effects that can be present for years after treatment and that can
lead to cardiac consequences also after long periods of no clinic sequelae. Patient numbers
with cancer problems will dramatically increase in the next years and thus every cardiologist
will need to have the correct information and the skills to manage these situations in the
correct way. This book will provide these tools for them.
