Managing the risks of cardiac therapy in cancer patients.

Overview

The purpose of this review was to highlight the more commonly used cardiac medications that should be closely monitored or possibly discontinued during cancer therapy. Often, older cancer patients are taking multiple pharmacotherapy agents for the treatment or prevention of cardiac disease when they face decisions about cancer treatment. Concurrent administration of drugs can result either in increased toxicity or decreased efficacy of either therapy. The benefits of the cardiac medications must be weighed against the effects of cancer therapy, and the role of drug metabolism also must be considered. For example, the benefits of cardiac medications such as anti-platelet agents, important in treating coronary artery disease, and anti-thrombotic agents, important for stroke prevention in atrial fibrillation, must be evaluated against an increased risk of bleeding during cancer therapy. It should be noted that some cardiac medications which act on hormonal receptors can theoretically stimulate growth of certain cancers. The concomitant management of cardiac therapy and cancer therapy is a common challenge in today's aging population.