JUNE 7 — Over the past ten years, cancer death rates have steadily dropped, giving millions of families a real reason to celebrate. Between advanced radiation techniques, targeted molecular drugs and immunotherapies, we are seeing clinical breakthroughs that used to feel entirely out of reach. The medical community deserves all the credit for this massive shift. For a lot of people, surviving a diagnosis that used to be a definitive death sentence is now just a reality of modern care.

But if we look at a patient’s life long after they leave the clinic, clearing the tumour turns out to be only the first half of the struggle. What good is beating a life-threatening illness if the treatment itself ends up quietly affecting the heart? That is where a relatively new medical branch called cardio-oncology comes in. It focuses entirely on a massive problem – the heart risks tied directly to modern cancer treatments. Older chemotherapies were infamous for very visible, predictable side effects; everyone knows about the hair loss and the intense nausea. Today’s therapies are much more sophisticated, but they also mess with the cardiovascular system in ways that are far harder to spot.

Some of these highly effective drugs can quietly weaken the heart muscle, spike a patient’s blood pressure or trigger random, dangerous heart rhythms. Because these drugs are keeping the patient alive, it’s easy to overlook the heavy toll they might be taking on their blood vessels. The real issue is that these heart complications don’t always show up during treatment; they can surface years, or even a decade, after a patient gets the all-clear. Data shows that cancer survivors who make it past the five-year mark face up to three times the cardiovascular risk of everyone else. A teenager who beats lymphoma or a young mother who recovers from breast cancer might look completely healthy, only to find themselves dealing with sudden heart failure in their 30s or 40s.

Beating cancer simply does not guarantee a clean bill of health down the road. The good news is that medical protocols are catching up. In the past, doctors faced a brutal dilemma. If a patient developed heart issues during chemotherapy, they usually had to stop the cancer treatment entirely. Today, oncology and cardiology work hand in hand. By tracking highly sensitive heart proteins in the blood and using advanced imaging like speckle-tracking echocardiography and cardiovascular magnetic resonance imaging, specialists can catch microscopic heart strain, early scarring or tissue inflammation before the patient feels a single symptom.

Spotting these red flags early means physicians aren’t forced to abruptly halt crucial oncology treatments. Instead, they can start the patient on standard heart medications like beta-blockers right away, shielding the heart muscle so the patient can safely finish their oncological treatments.

However, this doesn’t mean we can take these risks lightly. Patients undergoing heavy chest radiation or receiving anthracycline-based chemotherapies are at a much higher risk for “cardiotoxicity” – the medical term for heart damage caused by drugs. The early warning signs look like everyday fatigue – a little shortness of breath when walking up stairs, sudden weight gain from fluid buildup or a racing pulse. If ignored, these symptoms can quietly progress into chronic congestive heart failure.

Nevertheless, there is a massive difference between a risk that requires careful monitoring and one that should terrify a patient into avoiding cancer care altogether. The human body is an interconnected network; you cannot treat an organ in total isolation. Because of this, hospitals around the world are rushing to set up dedicated cardio-oncology clinics. The goal is to optimise a patient’s heart health before they even start their first round of chemotherapy, track them during the process and monitor them long after they are declared cancer-free.

Clinical data confirms that early teamwork between oncologists and cardiologists slashes the rate of long-term heart emergencies. However, public awareness is still lagging far behind the science. A shockingly low number of oncology patients remember ever being warned about potential heart risks before starting their regimens. From a public health standpoint, understanding your medical baseline, whether you smoke, have high blood pressure, or manage diabetes, matters just as much as knowing your cancer stage. This is why updated guidelines from major international heart associations now emphasise that a thorough heart check should be a routine prerequisite for any major cancer treatment plan.

The big takeaway from these medical advancements shouldn’t be fear; it should be empowerment. The era of modern oncology proved that cancer can be beaten. But it also leaves many survivors completely unaware of the long-term biological footprint left behind by their cure. Modern medicine demands a holistic approach that fiercely protects the brain, the lungs and the heart simultaneously.

What patients really need is clear information, not unnecessary fear.

As cardio-oncology becomes the standard of care worldwide, we are going to hear a lot more reports about treatment-induced heart conditions. This isn’t because cancer drugs are suddenly getting more toxic. It’s because we’ve finally become smart enough to track, find and treat these complications before they do permanent damage. Protecting the heart while conquering the disease is the next big step forward in medical history.

* Associate Professor Dr Noor Khairiah A Karim is the deputy director (clinical and sustainability), medical lecturer and consultant radiologist at Pusat Kanser Tun Abdullah Ahmad Badawi (PKTAAB), Universiti Sains Malaysia (USM) and an executive committee member of the Asian Society of Cardiovascular Imaging (ASCI).

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.