USF Health, Moffitt Cancer Center mark first year of Cardio-Oncology Program

Abby Jones was diagnosed with breast, kidney and lung cancers at Moffitt Cancer Center two years ago – all at age 29.

“Who knew I would have to deal with the threat of cardiovascular disease while I was being treated for cancer,” said Jones, a healthy non-smoker who through genetic testing discovered she had a rare disorder that greatly increased her risk of developing several types of cancer.

Jones shared her personal story about overcoming cancer and a chemotherapy-associated cardiac complication Feb. 17 during a luncheon marking the first year of the Cardio-Oncology Program jointly developed by USF Health and Moffitt Cancer Center. More than 130 community, USF and Moffitt leaders attended the educational event, along with several patients and their families.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Abby Jones of Ocala, Fla., center, was one of the first cancer patients to benefit from the Cardio-Oncology Program jointly established in late 2014 by USF Health and Moffitt Cancer Center. She poses here with here with her doctors, Moffitt oncologist Dr. Roohi Ismail-Khan, right, and USF Health cardiologist Dr. Michael Fradley.

The Ocala resident was one of the first patients to participate in the USF Health-Moffitt program, which aims to reduce the risk of cardiovascular complications and prevent cardiovascular disease in cancer patients and survivors.

Jones’ kidney and lung cancers were completely removed surgically. But, research has shown that Herceptin (trastuzumab), one of the chemotherapy drugs administered to help treat Jones’ breast cancer, can have significant toxic effects on the heart. So, Roohi Ismail-Khan, MD, Jones’ oncologist at Moffitt, made sure Jones’ heart was monitored routinely during chemotherapy. When an echocardiogram indicated reduced heart pumping function, Dr. Khan referred Jones to colleague Michael Fradley, MD, a USF Health cardiologist.

After a 7-week “vacation” from Herceptin until her heart function returned to normal and the addition of a low-dose blood pressure medication, Jones said, she was able to successfully complete the optimal chemotherapy regimen for her type of breast cancer last year without cardiotoxic side effects. She will continue to see Dr. Fradley and have her heart tested yearly.

Last weekend, Jones and her husband took their 3-year-old son on a trip to Disney World. “I definitely benefitted from this program,” she said.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

From left, Dr. Fradley speaks with Dr. Arthur Labovitz, chair of cardiovascular sciences at USF Health, and Dr. Charles Lockwood, senior associate vice president for USF Health and dean of the Morsani College of Medicine.

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Since its creation in late 2014, 520 patients have used the USF Health-Moffitt program – Florida’s first comprehensive academic cardio-oncology program. It is overseen by Dr. Fradley, assistant professor of cardiology at the USF Health Morsani College of Medicine, and Dr. Khan, a medical oncologist with the Center for Women’s Oncology at Moffitt.

“Based on our first year, this comprehensive and collaborative program is definitely filling a need,” said Dr. Fradley, a pioneer in the emerging field of cardio-oncology and director of the joint program. “It’s a partnership that will continue to strengthen as our patient volume grows and we expand our research and clinical efforts to reduce cardiac risk and improve outcomes for patients battling cancer.”

Today’s targeted cancer treatments are saving and extending lives, but some chemotherapy and radiation therapies can significantly damage the heart by aggravating preexisting heart disease or creating new cardiovascular problems.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Community leaders and officials from USF Health and Moffitt, as well as patients and their families, attended the educational event to raise awareness about the academic partnership that aims to reduce the risk of cardiovascular complications during cancer treatment.

Up to 30 percent of patients receiving cancer treatment experience cardiovascular complications – some not apparent until 10 to 20 years later, Dr. Fradley said. These cardiotoxicities may include heart failure, abnormal heart rhythms, heart attacks, high blood pressure and valve disease.

Moffitt and USF Health have begun research to find more effective ways to eliminate cardiac disease as a barrier to effective cancer therapy.

“Ultimately, our goal is to prevent these cardiotoxicities from ever happening,” Dr. Fradley said. “The last thing we want is for someone to survive their cancer and be left with lifelong cardiovascular disease.”

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The Cardio-Oncology program serves male and female patients equally, but Dr. Ismail-Khan adds that breast cancer patients are at extra risk for cardiotoxicity. A single breast cancer patient may receive several chemotherapeutic drugs (including such agents as anthracyclines, trastuzumab, pertuzumab and tyrosine-kinase inhibitors) as well as radiation therapy — all of which may cumulatively increase the individual’s risk of heart disease, she said. Age and pre-existing heart conditions add to the risk.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Dr. Lockwood called the academic partnership in the emerging field of cardio-oncology a “model” for other collaborations between USF Health and Moffitt.

Moffitt and USF Health have already conducted an exploratory study to determine whether patients with mutations of the BRCA1 and BRCA2 genes also have a higher risk for cardiotoxicity. The researchers found that breast cancer patients with these genetic mutations may be at higher risk than the general population for heart failure, and plan to delve deeper into the reasons why.

Another research question to be investigated, Dr. Ismai-Khan said, is whether risk stratification and cardiac rehabilitation can improve the outcomes of patients undergoing chemotherapy with cardiotoxic drugs.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Dr. Labovitz thanked the cancer survivors who shared their experiences and recognized the Moffitt partners who “have been instrumental in the success of the program.”

“The relationship between cardiology and oncology is an absolute must for the future of cancer survival,” she said. “Many novel Phase 1 drugs fail due to cardiotoxicity. If we can control the (damaging) side effects, we may have more treatment options for our patients.”

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Joining Dr. Fradley and Dr. Ismail-Khan as speakers at the luncheon were Arthur Labovitz, MD, FACC, chair of cardiovascular sciences at USF Health, Charles Lockwood, MD, senior vice president of USF Health and dean of the Morsani College of Medicine, and G. Douglas Letson, MD, executive vice president at Moffitt.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Among the luncheon speakers was Dr. G. Douglas Letson, executive vice president at Moffitt.

Recognizing that cardiovascular disease and cancer are the two leading causes of death, they praised the academic multidisciplinary partnership that seamlessly combines the expertise of cardiologists and medical and radiation oncologists.

“Just a few years ago, the field of cardio-oncology didn’t even exist and yet in a very short time our two institutions have developed a partnership to offer our community this unique and important resource,” said Dr. Labovitz, co-director of the USF Health Heart Institute.

“I see this Cardio-Oncology Program as a model for other collaborations between USF Health and Moffitt to make sure our patients collectively get the very best care than can,” Dr. Lockwood said.

In addition to comprehensive care and research, the partnership includes an educational component to teach Moffitt staff how to recognize signs of cardiotoxicity and patients the importance of reporting symptoms as well as healthy lifestyle changes to help reduce cardiac risk. A cardio-oncology fellowship training program has also been established, Dr. Letson said.

For more information on the Cardio-Oncology Program, please visit https://moffitt.org/tests-treatments/treatments/cardio-oncology/

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Abby Jones shared her personal story about overcoming cancer and a chemotherapy-associated cardiac complication.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

The event included lifestyle information about how to reduce the risk of cardiovascular disease, including a display of fat and sugar content in some popular foods.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

Bernadette Shields, Moffitt nurse coordinator for the Cardio-Oncology Program, provides support and education to patients.

Members of Moffitt Cancer Center and USF Health Department of Cardiovascular Sciences (Cardio-Oncology Program) present research pertaining to the effects of cancer treatments on the heart.

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Photos by Eric Younghans, USF Health Communications and Marketing