Blood & Cancer

Susan Dent, MD, codirector of the cardio-oncology program at Duke University in Durham, N.C., reflects on virtual grand rounds, telehealth, the screening of patients before clinic visits, and other new realities of cancer care in the age of COVID-19. Dr. Dent also discusses the importance of assessing breast cancer patients for cardiotoxicity. In Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about the importance of advance directives. *  *  *   Cardiotoxicity in breast cancer treatment HER2 drugs (such as trastuzumab) and conjugates If given appropriately, these drugs have limited cardiotoxicity. The mechanism of cardiotoxicity is a “stunning of the heart.” If there is a significant drop in left ventricular ejection fraction, hold the drug. When problems arise, they tend to occur early on. Important to assess baseline risk factors. Older individuals with underlying hypertension, diabetes, and other conditions need monitoring. Anthracyclines The appropriate/safe dose of