The European Health Center (ECZ) in Otwock is the third center in the world to start comprehensive treatment of cancer patients suffering from cardiovascular diseases at the same time, it was announced on Wednesday at a press conference in Warsaw.
The hospital in Otwock is organizationally the first facility of this type in Central and Eastern Europe, providing full cardio-oncology care.
Such centers will be established more and more often, because every second person with cancer has heart problems – suffers from coronary heart disease, arterial hypertension, arrhythmias or heart failure “- said Prof. Adam Torbicki, head of the Department of Pulmonary Circulation and Thromboembolic Diseases at the Medical Center for Postgraduate Education at ECZ.
Venous thrombosis and pulmonary embolism may be the first sign of an underlying tumor. Pulmonary embolism is also the second leading cause of death in cancer and other neoplastic diseases.
Such patients require intensive treatment, both oncological and cardiological, especially when the disease is already advanced. From the moment the disease is diagnosed, the cooperation of doctors of various specialties is needed. When it is absent, patients are sent from one specialist to another, because no one wants to undertake too risky treatment.
Prof. Tadeusz Pieńkowski, the head of the CMKP ECZ oncology clinic, admitted that he had previously had patients who had to be discontinued or discontinued oncological treatment due to cardiovascular complications. Now you can help them thanks to comprehensive care. There are such possibilities in the ECZ, where all the specialists necessary for such treatment are in one hospital. This ensures greater safety for both the patient and the doctors – emphasized Pieńkowski.
An example is a 39-year-old man with pulmonary embolism treated at the Center, who was diagnosed with a testicular embryonic tumor with metastases to the lungs and retroperitoneal space. He was given anticoagulant medication and only then underwent surgery and chemotherapy.
The case of a 78-year-old man with cancer of the rectum and prostate gland was extremely difficult. He had bypass surgery, heart failure and atrial fibrillation. Despite the enormous risk, his rectum was removed and he underwent hormonal treatment and chemotherapy. He was implanted with a pacemaker and continued oncological treatment.
Specialist treatment is required in patients whose tumor growth alone causes complications. An example is the life-threatening tamponade of the pericardium, where blood enters the pericardial cavity or becomes filled with other fluid, making it difficult for the heart muscle to relax. Pulmonary hypertension may also develop as a result of overgrowth of pulmonary arterioles. It requires immediate treatment.
Oncological treatment itself sometimes causes damage to the heart muscle. In this case, we strive to better predict which patients are most at risk of cardiological disorders – emphasized Prof. Torbicki. Echocardiography helps to determine the ejection fraction of the heart muscle. Even better results are achieved with the use of a CT and magnetic resonance imaging.
The blood also tests troponins, proteins that indicate damage to the heart muscle, and peptides that indicate a possible stretching of the heart muscle. Research is also conducted on genetic screening to detect patients more susceptible to damage caused by chemotherapy.
We do all this so that the patient does not have to stop the oncological treatment, but at best only to modify it – emphasized prof. Torbicki.
According to the director of ECZ, Dr. Anna Kieszkowska-Grudny, the dissemination of cardiovascular treatment gives better results and allows saving more patients, but may also bring savings in health care. We estimate them at 70-120 million per year – she added.
In Poland, at least 400 people live with cancer. people, including over 60 thousand. women with breast cancer. Many of them are at risk of relapse and other diseases, especially of the circulatory system, which may show up after 10, 15 or even 20 years.
In the case of breast cancer, 42 percent. of women die from cancer, but in 22 percent. cause of death is heart failure. In some patients, it can be prevented if appropriate treatment is administered in time – emphasized prof. Pieńkowski.
Zbigniew Wojtasiński (PAP)
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