Friday 30th September 2016
Mac Voice, the magazine for Macmillan professionals: Autumn 2016
Macmillan’s quick guide, available at macmillan.org.uk/cot, is aimed at helping primary care professionals manage this often unreported consequence of treatment
The heart can be affected by a number of cancer treatments. As more people are living longer with cancer, this also means that more people may be at increased risk of heart problems as a consequence of their treatment. Macmillan estimates that up to 625,000 people face poor health after cancer treatment. 
Primary care has a significant role to play in managing long-term consequences of treatment. [2,3] Primary care professionals have asked for more education about the late effects on heart health. 
How was the guidance developed?
The guidance, Managing heart health during and after cancer treatment, was developed by Macmillan and a multidisciplinary expert panel, including GPs and nurses. It has been endorsed by:
What does the guidance cover?
The following summary gives an overview of the different sections, and some examples of the recommendations given in the guidance.
Before cancer treatment – Advise patients on how to optimise heart health using the Macmillan booklet Heart health and cancer treatment, which was created in partnership with the BHF. Consider all cardiovascular risk factors, for example hypertension and diabetes, and optimise interventions for these without delaying cancer care pathways.
During treatment – During chemotherapy, any cardiovascular symptom should be investigated. Be aware of the cardiotoxic risks of treatment. Continue to review cardiovascular disease risk during long-term cancer treatment.
After treatment – Discuss the Treatment Summary with the patient. Offer the Macmillan booklet Heart health and cancer treatment. Begin regular cardiac function testing (by primary or secondary care) no later than six months after the end of cardiotoxic treatments. Screen people with cardiovascular risk factors at least annually.
Referral to Cardiology – Consider referral to Cardiology for people in certain situations and with symptoms as described in the guidance. This includes people with particular risks, such as planning for pregnancy, or abnormal cardiac function/symptoms.
Visit macmillan.org.uk/cot to download the full guidelines, or a one-page summary.
Why primary care is well placed to help
Sinead Clarke is a Macmillan GP Adviser and was part of the team that developed the new guidelines. Sinead says, ‘Primary care is best placed to work with patients to decrease their chances of cardiac problems after cancer treatment. For example, through regular blood pressure and health checks, I can ensure any potential consequences of cancer treatment are monitored and minimised. If a health problem is identified, I can work together with the patient to manage the problem, or refer them to appropriate services in a hospital.’