Cardio-Oncology & Immunology

How we prevent and manage heart damage from cancer treatment

Experts at UCSF Health provide education, assessments and preventive care for all types of heart damage related to cancer treatment. We care for people who are newly diagnosed with cancer, those currently in treatment and cancer survivors.

Our team also provides specialized care for people with existing heart conditions, such as heart failure or atrial fibrillation, who need cancer treatment.

Understanding cancer treatment and heart risks

Cancer treatments can damage your heart and blood vessels in several ways:

• Chemotherapy can weaken your heart muscle and cause pumping problems, which may lead to heart failure or arrhythmias (abnormal heart rhythm).

• Radiation therapy to your chest increases the likelihood of heart valve problems and coronary artery disease due to cardiac fibrosis (thickened heart tissue).

• Immunotherapy triggers your immune system to fight cancer, but increases the risk of inflammatory heart diseases, such as myocarditis.

• Targeted therapy can cause metabolic changes throughout your body and increase the risk of diabetes or high cholesterol, which can lead to heart problems.

Heart health risk assessment

We evaluate your heart health before, during and after cancer treatment, which helps us spot problems as early as possible. When possible, we identify and modify any preexisting risk factors that could increase your likelihood of cardiovascular complications.

Risk factors include:

• High blood pressure or cholesterol

• Smoking

• Obesity

• Family history of heart disease

• Diabetes

Cardiotoxicity prevention and treatment

We use many strategies to protect your heart during and after cancer treatment. Our team creates a personalized plan based on your risk factors and the type of cancer treatment you need.

We may recommend:

• Medications. Help manage blood pressure, cholesterol or diabetes.

• Lifestyle modifications. May include eating a healthy diet, more exercise or smoking cessation.

• Active surveillance. Monitors your heart using cardiac testing such as echocardiography or electrocardiography.

Specialized cardio-oncology and cardio-immunology programs

UCSF Health offers specialized care for a range of heart conditions and diseases related to cancer treatment, including:

• Carcinoid heart disease. Neuroendocrine tumors can release hormones that affect your heart valves, possibly leading to heart failure. At UCSF Health, our cardiologists, oncologists and heart surgeons work together to provide comprehensive treatment for patients with carcinoid heart disease.

• Cardiac amyloidosis. Cardiac amyloidosis is a buildup of proteins in your heart that makes pumping blood difficult. Sometimes it's the result of certain blood cancers. Our experts have been instrumental in developing guidelines to diagnose, treat and monitor people with this condition.

• Clonal hematopoiesis of indeterminate potential (CHIP). CHIP is a condition where genes in blood cells change (mutate) over time. CHIP increases your risk for cardiovascular disease (CVD) and certain blood cancers. Our CHIP-CVD specialists provide comprehensive diagnostic testing and treatment for patients with this mutation.

• Myocarditis and pericarditis. Immune checkpoint inhibitors, a type of immunotherapy treatment, can cause myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the membrane surrounding the heart). We are at the forefront of research to better understand and care for cardiac complications related to immunotherapies.

Cancer survivorship and wellness

We focus on promoting cardiovascular health and whole-person wellness in cancer survivors. Our survivorship program offers symptom management, counseling, support groups and other resources to help you thrive after cancer treatment.