Building cardio-oncology nursing capacity in Asia: Current practice and future directions

Cardio-oncology has developed rapidly as cancer survival improves and cardiovascular complications related to cancer treatment receive increasing attention. In Asia, however, the development of cardio-oncology nursing remains uneven. This narrative review summarizes the available evidence on cardio-oncology services and nursing practice in Asia, with most of the published literature coming from China, Japan, and South Korea, together with reports from other Asian settings where available. Current evidence is largely derived from tertiary or specialist centers. Nursing roles, educational preparation, models of care, and nursing-sensitive outcomes are not consistently described. Reported nursing activities include cardiovascular risk assessment, symptom monitoring, patient education, treatment adherence support, care coordination, and survivorship care. Common challenges include limited specialist education, fragmented oncology and cardiology services, unequal access to specialist care, differences in nursing regulation and scope of practice, and limited nursing research from Asian settings. Based on the available regional evidence and relevant international experience, we propose competency-based and service-capacity frameworks to guide local service development and future evaluation. Initial development should focus on staff preparation and clear pathways for cardiovascular risk identification, referral, and escalation. More specialized nursing roles, including nurse-led and advanced-practice services, may be developed where workforce capacity, professional regulation, and clinical governance allow.