201 - ABC'S OF CARDIO-ONCOLOGY REHABILITATION: AN EMERGING FIELD

Saturday, October 29, 2022

3:15 PM – 4:00 PM EDT

Location: Canada Hall 3

Target Audience: Academic cardiovascular health professionals and researchers, Clinical cardiologists, Trainee (clinical)

Chair(s)

Paul Oh, n/a (he/him/his)

Medical Director, GoodLife Fitness Chair and Senior Scientist
University Health Network
University of Toronto
Toronto, Ontario, Canada

Presenter(s)

SA

Scott Adams, RKin, CSEP-CEP, PhD

Assistant Professor & Assistant Scientist
Toronto, Ontario, Canada
Karol G. Hernandez-Gutirrez, MD

Clinical Fellow in Cardiac Rehabilitation and Prevention
UHN
UHN
Toronto, Ontario, Canada
MN

Michelle Nadler
Fernando Rivera-Theurel, MD

Clinical Fellow
University Health Network
University of Toronto
Toronto, Ontario, Canada

Planning Committee Member(s)

Husam M. Abdel-Qadir, MD, PhD

Cardiologist-Scientist
Women’s College Hospital, University Health Network
Toronto, Ontario, Canada
PB

Priya Brahmbhatt, RKin, MSc.

PhD Candidate at the Faculty of Kinesiology and Physical Education
Toronto, Ontario, Canada
TC

Tracey J. Colella, RN, PhD

Scientist and Clinician
CACPR/CCCN
University of Toronto
Toronto, Ontario, Canada
AL

Ann-Sophie Laberge, MD, FRCPC

General and vascular internist
Quebec, Quebec, Canada
Paaladinesh Thavendiranathan, MD, FRCPC

Director, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, TGH
Toronto General Hospital
University of Toronto
Toronto, Ontario, Canada
PR

Paula Ribeiro, PhD

Assistant Director A Coeur Lab; Research Associate
Montreal, Quebec, Canada

Learning Objectives:

At the conclusion of this session, participants will be able to:

recognize the role and potential impact of Cardio-Oncology Rehabilitation in primary and secondary CVD prevention and mortality risk reduction in cancer survivors;
increase awareness of CORE as an intervention to improve cardiovascular outcomes with the cancer-specific considerations for patient assessment, intervention, and monitoring; and
promote a more complete understanding of the field by integrating the theoretical and practical considerations for Cardio-Oncology Rehabilitation.

Cancer and cardiovascular disease (CVD) are the leading causes of mortality worldwide. Emerging evidence demonstrate that both cancer and cardiovascular disease are heavily influenced by a shared cluster of modifiable risk factors (e.g. physical inactivity, sedentary lifestyle, suboptimal diet, and obesity). Understanding the biological overlap between these conditions is, therefore, critical to identify common therapeutic and preventive strategies. Cancer survivors have a higher risk of developing and dying from CVD compared to the general population. Multiple interrelated mechanisms contribute to this risk, including exposure to anticancer therapies that directly injury cardiovascular system organs and the subsequent adverse effects on behaviour and lifestyle factors. Despite growing awareness of these risks, cardiac rehabilitation (CR) – a multimodal intervention approach that may positively impact multiple competing mechanisms of cancer-related CVD – has been underused within this high-risk population.

Indeed, CR is a cornerstone of primary and secondary CVD prevention across most relevant clinical populations. The combined elements of the CR model (i.e. exercise, pharmacologic risk factor management, nutrition, smoking cessation, and education) have collectively been shown to improve cardio-respiratory fitness and quality of life while reducing morbidity and mortality in individuals at risk or with established CVD. Thus, a CR-based intervention model (i.e. Cardio-Oncology Rehabilitation (CORE) may be ideally suited to improve CVD outcomes in cancer survivors.

The overarching objective for this session is to increase awareness of CORE’s potential role and therapeutic impact. This 45-minute workshop will review the key concepts and early evidence supporting the therapeutic potential of CORE to improve CVD outcomes (e.g. cardiorespiratory fitness, CVD risk factors) and mortality in oncology. Specifically, the workshop will briefly review the mechanisms of cardiovascular injury, identify higher risk populations, and discuss the primary considerations for patient screening, safety and intervention delivery / optimization within the context of epidemiological research that highlights the potential for long-term benefits. The workshop format includes:

a brief overview of the background and current evidence,
cardiologist-led small group discussions on clinical cases and outcomes,
real-time audience polling during the first two sections, and
an interactive Q&A session.

The workshop content and structured interactive activities will be strategically coupled to stimulate interest and excitement for the topic and a broader understanding of the primary topics discussed throughout.