Cardiotoxicity in oncology: a cancer-centred perspective on current evidence and future directions

With improved cancer survivorship, cardiovascular disease (CVD)-related mortality in cancer survivors has risen. Cardio-oncology is an established subspecialty dedicated to the prevention and treatment of the adverse cardiac effects of cancer therapies, facilitating the continuation of cancer treatment, improving quality of life and long-term care. This review explores recent evidence and challenges in understanding and managing cardiotoxicity in respect of five cancers commonly encountered by the general physician. We focus on long-term cardiovascular risks of treatments, the bidirectional relationship between cancer and CVD and cardiotoxic mechanisms. We critique current methods of risk assessment and stratification of cardiotoxicity and future directions for prevention and management. Finally, emerging evidence for the role of lifestyle measures in cardioprotection is recognised.