Feasibility and growth of a dedicated cardio-oncology service at a large victorian tertiary cardiac centre

Background Advances in cancer therapy have significantly improved survival, however, cardiovascular toxicities during treatment and long-term cardiac complications remain an ongoing challenge. Dedicated cardio-oncology services aim to address this gap, yet real-world data on service growth and clinical impact are limited, particularly in Australia. A dedicated cardio-oncology service was established at a large Victorian tertiary cardiac centre, demonstrating feasibility and increasing service utilisation. Purpose This project audited the growth of a newly established cardio-oncology service to evaluate patterns of referral, cardiovascular management, and cancer treatment completion. We hypothesised that structured cardio-oncology care would support completion of cancer therapy with low rates of cardiovascular-related interruption. Methods A retrospective audit of all patients referred to the cardio-oncology service at a Victorian tertiary cardiac centre was undertaken between 1st July 2023 and 30th June 2025. Electronic medical records were reviewed to obtain baseline demographics, cancer diagnoses, cardiac investigations and medication changes. Primary outcomes included the percentage of cancer treatment completion, rates of hospitalisations and, mortality due to cardiovascular causes. Results 374 patients were included (mean age 65.4±14.9 years; 46% female, median follow up 13 months), total of 764 reviews. Cardiovascular comorbidities included hypertension (57%), dyslipidaemia (55%), diabetes (30%), smoking history (49%) and ischaemic heart disease (24%). Haematological malignancies were most common (32%), followed by breast (18%), lung (11%) and gastrointestinal cancers (11%). 50% of referrals occurred during active cancer treatment, heart failure being the main indication for referral (42%). Cardiovascular management changes occurred in the majority (69% with cardiovascular medication modifications, 502 echocardiograms, 50 cardiac MRI, 48 cardiac CT, 12 invasive angiograms performed). Only 9% (n=21/232) required a change/cessation in cancer treatment due to a cardiac cause. 1/36 patients died from a cardiovascular cause and 23 had cardiac hospitalisations (mostly for heart failure). Conclusion Dedicated cardio-oncology services are feasible and have demonstrated significant growth since inception in this tertiary Australian setting. Most patients were able to complete cancer treatment without interruption. These services may help reduce short- and long-term cardiovascular complications in oncology patients.