TKG Oncology Voices - Translating insights into action TKG Oncology Voices - Translating insights into action
Oct 01

Cardio-Oncology: Ongoing healthcare communications and surveillance

An Interview with Dr. Carrie Lenneman – PART 4 of 4

In June 2021, The Kinetix Group interviewed Dr. Carrie Lenneman, a cardiologist who specializes in working with cancer patients who have a higher-than-normal risk that their cancer treatment may affect their heart. She also works with patients who have had previous cancer treatment and are experiencing symptoms that may be related to their prior treatment. Dr. Lenneman is Medical Director of the Cardio-Oncology Clinic at the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham (UAB) in Birmingham, Alabama.

Cardio-oncology is a subspecialty area of cancer care that has become increasingly important as the number of long-term cancer survivors continues to go up. Advancements in cancer therapies have tremendously improved the long-term survival of patients. However, some of the treatments can be hard on the heart, especially for those individuals who may have other medical conditions, or who have sensitivities to their therapies.

What follows is Part 4 of a transcript of our interview with Dr. Lenneman, edited for this format.

Warren Smedley: Are there any good digital tools that you know of that can help patients stay on track?
Dr. Lenneman: Great question. I’m sure there are. I have not developed or delved much into the digital world, like reminder apps and such. I do know that they’re doing a lot with that sort of thing in surgical oncology. Certainly there’s a role for digital apps and digital communications, especially those linked through our healthcare system. That would be important for sure. And I’ll say that definitely with telemedicine I think we’ve improved our ability to reach out to patients and to monitor and do more remote care.
Warren Smedley: Final question for you. Are there other gaps that you think we as health system administrators, hospital systems, oncology programs, societies, should be focused on trying to address, to prevent exacerbation of problems for patients?
Dr. Lenneman: Definitely. I think we need to make sure that, as our patients are finishing up their acute treatment, we provide them with a comprehensive surveillance care plan. I know this has been especially important at UAB, and we have made a huge push to provide treatment summaries for the patients so that they can then know, yes, I got an anthracycline. They also need to get a post-treatment echo and then maybe have some yearly, or every other year, scheduled surveillance, depending on how high-risk a patient is. For example, in our prostate cancer patients we need to make sure they follow up when they may be at increased risk for cardiovascular issues due to alterations in the hormones that occur and make sure that they realize the effects of that inter-playing with causing elevations in lipids, maybe making them at higher risk for having uncontrolled blood pressure, and how important controlling those risk factors are.

So I think our care plans are absolutely essential and probably even need to have a more focused sort of drill down on what the potential cardiovascular effects might be and what the parameters are that we need to be hitting. Handing a patient a book to go with that care plan would be helpful too. Controlling these risk factors are so important.

I also think we need help disseminating this information to the primary care providers or other healthcare teams. Once they leave our immediate care, we need to equip the patient as much as we can to proactively manage their health.

Warren Smedley: There are certainly a lot of moving parts here. It seems very challenging to empower the patient to be healthy, to optimize their outcomes, and do the best that they can. It’s very complex.

Thank you so much for taking the time to update us on all of this. Is there anything else that you think would be important for your colleagues, especially those who aren’t in cardio-oncology, to know or to think about?

Dr. Lenneman: One thing I think that is sort of new and novel are these immunotherapies, immune checkpoint inhibitors. From a cardiovascular standpoint, we’ve been worried and more focused on trying to identify any issues that may develop during the first couple of cycles of treatment. We are looking for myocarditis or inflammation that can occur with that. I think now, as we’ve been using more of these therapies in patients, we’re realizing they’re at increased risk of development of atherosclerosis. And again, our metastatic melanoma patients who may have received these immune checkpoint inhibitors, they’re living very long. Jimmy Carter is sort of the poster child for it. And so we really need to focus on making sure that we’re being diligent about screening and controlling risk factors. Prevention is key.
Warren Smedley: Very good. Well, thank you so much, Dr. Lenneman. This has been an outstanding discussion. We appreciate your insights. It’s really important for all of us to understand the complexities here, so that we can all come together and improve the lives of our patients that we work with. I really enjoyed working with you at UAB, and appreciate how you are always striving to make a difference in patients’ lives. Thank you so much for taking the time today. We appreciate you and all you do.
Dr. Lenneman: Thanks Warren. I appreciate the opportunity. Great chatting.

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