Cardiotoxicity surveillance in cancer patients during and after treatment • Some cancer treatments (i.e., anti-HER2, BRAF-MEK treatments, clinical trials) require frequent surveillance of cardiac function (i.e., every 3 months)
• Patients with known cardiotoxicity, or with known treatments that can cause long-term cardiotoxicity (i.e., anthracyclines, radiation) may not get timely surveillance imaging • Minimize cardiac imaging to patients who are symptomatic
• Multidisciplinary discussion with hematologist/oncologist about reducing frequency of cardiotoxicity screening, especially if prior serial testing unremarkable
• Limited imaging protocols to evaluate LVEF to minimize acquisition time
• Defer primary prevention assessment (i.e., dyslipidemia management) unless critical to care of patient
• Telemedicine visits for patients who do not require face-to-face assessment for medical issues (i.e., blood pressure/lipid management/stable CHF)
• Defer asymptomatic long-term cancer survivor surveillance (i.e., assessment of ventricular and valvular function) if no symptoms