All too often, people who receive cancer treatment experience dangerous side effects that can affect their heart. Others put off heart care while they focus on cancer treatment. Still other patients have heart problems from cardiac amyloidosis. This condition has effects similar to cancer.
At the Washington University and Barnes-Jewish Heart & Vascular Center, experts from different specialties work together to identify and resolve these heart issues. While you’re receiving cancer therapies, we focus on protecting the rest of you — starting with your heart.
Leaders in Cardio-Oncology and Amyloidosis Care
Our Cardio-Oncology and Amyloidosis Center of Excellence brings you care from cancer experts and heart specialists. We are international leaders in patient care and innovative clinical research. We offer:
- Coordinated care: You receive care from medical and radiation oncologists (cancer specialists) and cardiologists (heart specialists). Our team meets regularly to be sure you receive the most appropriate therapies for your needs. Often, you can have appointments with your cancer and heart team on the same day. This coordination keeps your treatment on track.
- Internationally known expertise: Our cardio-oncology program is one of the world’s largest. We work with other experts around the globe to deliver the latest advances to protect your health.
- Complete heart risk screening: Our team screens you for cardiac injury risk before you start chemotherapy. Our goal is to prevent heart damage or spot it as early as possible to limit long-term harm.
- Timely treatment: We know that cancer therapy cannot wait. We see patients in the hospital and on an outpatient basis. In either case, we see you as quickly as possible — often within a week or less — to keep your care moving forward.
- Full range of surgery and nonsurgical intervention: We offer many therapies to treat arrhythmias (heart rhythm disorders). Our team delivers surgical and nonsurgical heart valve repair and replacement. And we provide organ transplantation through our transplant center.
- Care where you are: You can receive cardio-oncology care wherever you receive other care from Barnes-Jewish Hospital doctors. We see patients at Barnes-Jewish Hospital in St. Louis City, Barnes-Jewish West County Hospital and Barnes-Jewish Center for Advanced Medicine – South County. See our locations.
What Is Cardio-Oncology?
Cardio-oncology is a highly specialized area of cardiology (care for the heart). Cardio-oncologists work to prevent and treat heart problems due to cancer and cancer therapy. We use diagnostic testing, medical management and interventional and surgical procedures to treat these problems.
To help manage cancer therapy, we work closely with your team at The Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University Medical Center. Together, we seek to limit cardiotoxicity (heart damage) from cancer or cancer treatment. Our ultimate goal is to improve the survival and quality of life of patients with cancer. We work to offer timely treatment so that heart disease isn’t a barrier to receiving cancer therapy.
What Is Cardiac Amyloidosis?
Cardiac amyloidosis occurs when abnormal proteins build up in your heart. The protein buildup can cause heart failure or arrhythmia (heart rhythm disorders). Amyloidosis isn’t always cancer, but it affects the heart in ways that are similar to cancer. For that reason, our cardio-oncologists also treat amyloid heart disease.
There are more than 30 kinds of amyloidosis. Two main types affect the heart:
- Amyloid light-chain (AL) amyloidosis: One of the two most common types of amyloidosis, AL amyloidosis results from a problem with blood plasma cells in the bone marrow. It can affect your body like multiple myeloma, a blood cancer. Chemotherapy is the most common treatment. Learn more about AL amyloidosis.
- Amyloid transthyretin (ATTR) amyloidosis: The other common type of amyloidosis, ATTR occurs when your liver makes too much of a normal protein called transthyretin (TTR). Sometimes ATTR is an inherited condition. Read more about ATTR amyloidosis.
Diagnosing amyloid heart disease
We see many patients after a search for answers that can be long and frustrating. Our specialists use a wide range of tools to diagnose amyloid heart disease so that you can get the appropriate treatment. Find out more about amyloidosis diagnosis and treatment.
Depending on your heart symptoms, an amyloid heart disease diagnosis may include:
- biopsy to look for amyloid fibrils (protein deposits) in a sample of heart tissue
- blood and urine tests that can show markers of amyloidosis in your bodily fluids
- diagnostic catheterization, which allows doctors to look inside your heart
- electrophysiology studies to detect and repair arrhythmia and heart rhythm disorders
- genetic testing to understand whether an inherited gene mutation (change) is causing ATTR amyloidosis
- imaging tests such as echocardiography, which provides very clear pictures of your heart, and cardiac MRI, CT and PET tests to produce 2D and 3D pictures and videos of your heart
- technetium pyrophosphate scan to gauge heart damage and differentiate between AL and ATTR amyloidosis
Amyloidosis Care and Cardiotoxicity Treatment to Improve Cancer Survivorship
Both amyloidosis and the side effects of cancer treatment can affect your entire body. When cancer treatments damage the heart, the condition is called cardiotoxicity. Appropriate care for cardiotoxicity can improve cancer survivorship.
To address all your needs for both conditions, we have close working partnerships with medical specialists in many disciplines. Your care includes:
- Heart care: We carefully assess how amyloidosis affects you. Then we develop a personalized cardiac amyloidosis plan to minimize damage to your heart. You have access to leading treatments for arrhythmias and heart failure.
- Medication management: The right medication can help many people avoid cancer-related heart effects. Our team has the expertise to reduce heart damage. For instance, statins typically treat high cholesterol. But they may also prevent or protect from a heart attack or other vascular problem during cancer treatment.
- Cancer treatment: You receive integrated cancer care from your cardiologists and doctors at Siteman Cancer Center. Whenever possible, we coordinate your clinic appointments to minimize travel and be sure we answer all your questions. Your team stays informed about your treatment so you can have confidence in your care and focus on your well-being.
- Organ transplant: In advanced cases, heart transplantation may be appropriate. Our teams perform heart transplant and liver transplant for patients who qualify.
Our Cardio-Oncology and Amyloidosis Team
Our team is one of the world’s most respected. We are among the few programs that train the next generation of physicians in the fields of cardio-oncology and amyloidosis. That level of knowledge assures that you are in expert hands. Find a doctor.
Your care team includes the following types of physicians:
- cardiologists who specialize in protecting your heart from heart failure and other concerns
- electrophysiologists, cardiologists trained to diagnose and treat arrhythmia
- gastroenterologists who specialize in disorders of the stomach and intestines
- hematologists who specialize in blood disorders
- interventional cardiologists who perform minimally invasive, catheter-based procedures
- nephrologists who specialize in treating kidney disorders
- neurologists, nervous system specialists who treat conditions related to ATTR amyloidosis
- oncologists who specialize in cancer treatment
- pathologists who analyze laboratory results to offer an accurate diagnosis
- radiologists who analyze images of your heart to help diagnose your condition
Research and Clinical Trials for Amyloidosis and Cardio-Oncology
Our teams actively lead and participate in research studies to discover and assess new ways to treat these challenging conditions. You may have access to new investigational therapeutic options that are not ordinarily available. Other research opportunities seek to develop new knowledge to help future patients. Learn more about our innovation.
To make an appointment with a Washington University cardio-oncology or amyloidosis specialist at Barnes-Jewish Hospital, call 314-362-1291.