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Session on Cardio-nephrology: cardiotoxicities of cancer in childhood cancer survivors
By Steven E. Lipshultz, recorded at TAO (Transatlantic Oncology meeting), Nov 20-21, 2014, Paris
Successful treatment of childhood cancer used to be defined by 5-year event-free survival, but the tremendous advances in cancer treatment enable oncologists to focus on toxicities and late effects. Steven E. Lipshultz discusses the new paradigm that the successful treatment of cancer is determined by the balance between oncologic efficacy and toxicity/late effects as measured by quality of life for the patients and their families over a lifespan. This is important as the global risk of premature symptomatic cardiovascular disease is elevated in childhood cancer survivors and long-term follow-up studies have shown that cardiovascular deaths continue to go up at an exponential pace even decades after exposure to cardiotoxic therapy.The five stages in the course of pediatric ventricular dysfunction are: presence of risk factors, cardiomyocyte injury or impairment, maladaptive changes, cardiomyopathy, heart failure or clinically significant condition and rhythm abnormalities. Steven E. Lipshultz reviews preventive strategies and treatment options, stressing the need for tailored follow-ups and therapies.
Steven E. Lipshultz, Wayne University, Detroit, USA