A cardio-oncology experience in Italy

AIMS: Anti-cancer agents with cardiovascular side effects multiply, often interfering with effective oncology treatments, and thus the relationship between cardiologists and oncologists should be closer. We carried out a regional-based survey on behalf of Associazione Nazionale Medici Cardiologi Ospedalieri to analyse the status of cardio-oncology in Tuscany. METHODS: A short questionnaire was sent out to all cardiology divisions across Tuscany (n = 36). The questionnaire was made up of 13 questions divided into four blocks: cardio-oncology census and inner organization; multidisciplinary team and specific training; oncology-related workload; need for and availability of cardiac MRI. RESULTS: Twenty-five centres out of 36 sent back the completed questionnaire and so were included in the survey. An inadequacy of cardio-oncology services surfaced, with only 20% of institutions offering a cardio-oncology service and 28% possessing a trained cardiology team. The majority of cardiologists regarded as useful a specific training (72%), and the foundation of a distinct service (55%), and 68% assumed cooperation with oncologists as a way to improve performance. The majority of the workload involves ECGs and echocardiograms with a mean monthly number of requests ranging between 10 and 40. Cardiac MRI and computed tomography scans are used in selected cases, but all cardiologists consider them useful. CONCLUSION: To date, cardio-oncology in Tuscany can be considered as an unmet need. We should improve dedicated services by means of specific training and multidisciplinary teams. The definition of a regional task force and appointed centres with known expertise could also help. To make this upgrade possible, a financial effort is vital.