In Belgium, cardio-oncology represents an important public health challenge. Currently, 200 000 patients are estimated alive within 5 years of being diagnosed with cancer (1) and it has been well documented that one of the highest risk for cancer survivors is cardiovascular morbidity and mortality that remain increased even in the long run i.e. long after cancer has healed. In addition, it is increasingly proven that cardiovascular diseases and cancer share common risk factors (age, smoking, obesity, inactivity…) and present similarities, interactions and coexistence. One other important aspect is the existence of anticancer treatment related cardiotoxicities, which are sometimes delayed. If some are well-known, we are also facing an increasing incidence of unexpected cardiac toxicities with the wider use of the new anticancer agents. For all these reasons, cardio-oncology appears as an emerging discipline within cardiology, requiring specific knowledge as well as practical and technical skills.
All over the world, the cardio-oncology discipline is slowly structuring itself: experts come together in teams, working in dedicated cardio-oncology clinics and services (2). In Belgium, to promote the development of the cardio-oncology discipline but also cardio-oncology clinics and services, a Cardio-Oncology Council has been approved in February 2020. The Council is a constituent body of the Belgian Society of Cardiology (BSC) and gathers experts from Belgian universities' cardiology and medical oncology departments. The Council has been created to stimulate throughout the country, research, teaching, knowledge exchange and educational activities, focused on acute and long term cardiovascular complications of cancer treatments. The Council aims also at harmonising the care of the patients suffering from anticancer treatments cardiac toxicities through the transposition of international guidelines into local protocols.
In 2019, the Belgian Society of Cardiology (BSC) conducted a survey, published in 2020, to establish an inventory of cardio-oncology practice in Belgium (1). A short questionnaire was sent to 606 members of the society. The data from a total of 159 responders were collected and analysed. A dedicated cardio-oncology clinic was present in only 40% of the hospitals, with only 26% of responders being in charge of more than 20 patients per year. The majority of responders rated their knowledge as "fair" for the management of patient with common anticancer treatment related cardiotoxicities such as left ventricular dysfunction and atrial fibrillation and 44% were not aware or did not yet use the 2016 ESC position paper on the management of cancer patients, emphasising the important and urgently needed educational role of the recently created Belgian Cardio-Oncology Council. To date, no specific cardio-oncology teaching program is organised yet, but the development of such an educational program is under consideration.
About the Authors
Chairperson of the Cardio-Oncology Council, Cardiology Department, University Hospital of Liege, Belgium
Vice-Chaiperson of the Cardio-Oncology Council, Cardiology Department, Universitaire Ziekenhuis Antwerpen, Belgium
President of the Belgian Society of Cardiology, Cardiology Department, University Hospital of Liege, Belgium