New partnership at Orlando Health keeps cancer patients' hearts healthy
By Kimberly Wiggins, Reporter -
ORLANDO, Fla. (WOFL FOX 35 ORLANDO) -
As if cancer patients didn't have enough to worry about, some of the most aggressive cancer treatments can lead to heart problems later on down the road. At Orlando Health at UF Health Cancer Center, doctors are trying something new -- setting up a cancer patient with an oncologist and a cardiologist.
Dr. Lissette Olivarria was diagnosed with stage three breast cancer almost six years ago. The mother of two fought it. The cancer went into remission for two years, but it recently returned.
"At this point, it's already stage four," said Olivarria. "It spread to my lungs and my bones but I'm here and stronger than ever."
Her doctors at Orlando Health fought with her.
Breast Oncologist Dr. Rebecca Moroose said Olivarria's medicine was killing the cancer, but also hurting her heart.
"Part of our obligation as cancer doctors is whenever we give a treatment we have to explain all of the possible complications." said Dr. Moroose. "You can imagine when they hear they might have a heart complication, they're very nervous."
"I already receive one of the most cardio-toxic medicines at the beginning of the treatment," said Olivarria.
So the hospital came up with a new solution to an old problem.
"The damage to the heart could not be prevented," said Dr. Demori. "It could not be treated, once done it's done."
Heart problems resulting from cancer treatments include cardiomyopathy - a disease that weakens and enlarges the heart muscle. As the condition worsens it can lead to heart failure or irregular heartbeats. Other potential cardiac conditions include heart attack, arterial valve problems, and damage to the heart membrane.
That's why Dr. Carolina Demori and the rest of the cardiology department paired up with the Breast Oncology department at the beginning of this year.
Orlando Health Heart Institute and UF Health Cancer Center at Orlando Health developed the new Cardio-Oncology Program to help keep hearts beating strong throughout breast cancer treatments. The program is made up of a multidisciplinary team including cardiologists, oncologists, advanced nurse practitioners, and other clinicians, working together to protect hearts.
"It's a perfect combination," said Olivarria.
With the program, clinicians evaluate patients prior to receiving treatment for a baseline assessment of their hearts. The baseline helps cardiologists detect changes as they monitor patients throughout the course of cancer treatments. Testing before, during, and after cancer treatments may include echocardiograms, blood tests, and other diagnostics to show markers and indications that a person has heart damage, or is at high risk to develop heart problems. If heart damage is detected, or risk factors are determined, cardiologists and oncologists work together to adjust cancer treatments, or prescribe heart medications. The changes may prevent heart damage, reverse damage, or help stop the damage from getting worse.
The testing is important because sometimes problems can take decades to flare up.
"Unfortunately, on my first visit to the cardiologist, the EKG was not normal," said Olivarria.
Now, two sets of doctors are fighting with her. Demori said Olivarria's not alone.
"We thought it was only a small percentage of patients who will get heart damage," said Dr. Demori. "We now know that even up to 60-percent of the patients can get damage to the heart."
And it seems to be working. Olivarria said her doctors have noticed improvement.
"So far, it's stable," said. Olivarria.
"And I've had a couple of patients where I've told them you know your cancer saved your life because some have come in and gone for their baseline evaluation and have been found to have silent heart disease," said Dr. Moroose.
"We can actually see the improvement in the heart function so it's very encouraging to be able to call the oncologist and say hey, you can start back," said Dr. Demori.
The program is beginning with a focus on patients being treated for breast cancer who receive chemotherapy or radiation therapy on the left side of their chest. There are future plans to expand the program to help patients with other cancers.
Doctors also told FOX 35 they're open to working with a patient's cardiologist even if she or he doesn't work at Orlando Health.