Skip to main content
. Author manuscript; available in PMC: 2021 Nov 10.
Published in final edited form as: J Am Coll Cardiol. 2020 Nov 10;76(19):2267–2281. doi: 10.1016/j.jacc.2020.08.079

TABLE 2.

Specific Core Medical Knowledge Elements for Cardio-Oncology Training

  1. Understanding of the basic principles of cancer biology, including tumor development, growth, and dissemination

  2. Knowledge of the epidemiology, diagnosis, staging, management, and prognosis of common solid tumors
    1. Glioblastoma
    2. Head and neck cancers
    3. Thyroid cancer
    4. Lung cancer
    5. Breast cancer
    6. Esophageal and gastric cancer
    7. Colorectal cancer
    8. Pancreas cancer
    9. Liver cancer
    10. Gallbladder cancer
    11. Renal cancer
    12. Bladder cancer
    13. Testicular cancer
    14. Prostate cancer
    15. Ovarian cancer
    16. Endometrial cancer
    17. Cervical cancer
    18. Melanoma
    19. Carcinoid
  3. Knowledge of the epidemiology, diagnosis, staging, management, and prognosis of hematologic malignancies
    1. Leukemias
    2. Lymphomas
    3. Multiple myeloma
    4. Amyloidosis
  4. Understanding of cardiac tumors benign, malignant, and metastatic
    1. Knowledge of the types and differential diagnosis of cardiac masses
    2. Utilization of multiple advanced cardiac imaging techniques in the diagnosis of cardiac tumors
    3. Understanding and utilizing interventional techniques for tissue diagnosis (biopsy)
    4. Understanding the clinical decision making for treatment of cardiac tumors, surgery and/or systemic therapy
  5. Diagnosis and management of oncology emergencies (with cardiovascular disease aspects)
    1. Superior vena cava syndrome
    2. Disseminated intravascular coagulation
    3. Cardiac tamponade
    4. Fulminant myocarditis
  6. Knowledge of the principles and (general) toxicities of cancer therapies
    1. Classes, mode of action, and toxicities of systemic chemotherapies
    2. Classes, mode of action, and toxicities of targeted therapies
    3. Classes, mode of action, and toxicities of hormone therapies
    4. Classes, mode of action, and toxicities of immunotherapies
    5. Types, physics, planning, and toxicities of radiation therapy
    6. Types, conditioning, and toxicities of bone marrow transplantation
    7. Types, general conduct, and complications of oncological surgery
  7. Understanding of the cardiovascular complications from cancer therapies
    1. Diagnosis and management of chemotherapy-induced cardiomyopathy
      1. Molecular mechanisms underlying cardiotoxicity with conventional chemotherapies, including anthracyclines
      2. Molecular mechanisms underlying cardiotoxicity with targeted therapies
      3. The cellular and molecular mechanisms underlying immune check point receptor therapy cardiotoxicity
      4. Workup and diagnosis and management of chemotherapy related heart failure
    2. Diagnosis and management of pericardial complications of malignancy
      1. Pericarditis
      2. Pericardial effusion/tamponade
      3. Pericardial metastases
    3. Diagnosis and management of vascular toxicity in cancer therapy
      1. Venous thromboembolic complications in the cancer patient
      2. Arterial disease complications in the cancer patient including coronary artery, carotid artery, and peripheral arterial disease with acute and chronic presentations
      3. Vasculitis
      4. Thrombotic microangiopathy
      5. Systemic hypertension
      6. Pulmonary hypertension
    4. Diagnosis and management of cardiac arrhythmias in cancer therapy
      1. Prolongation of the QT interval
      2. Atrial tachyarrhythmias
      3. Ventricular tachycardias
      4. Bradycardias
      5. Cardiac device management
      6. Autonomic dysfunction
    5. Diagnosis and management of radiation-induced heart disease
    6. Diagnosis and management of cardiovascular diseases in the bone marrow transplant patient
  8. Understanding cardiovascular evaluations before, during, and after cancer therapy
    1. Echocardiography including strain imaging
    2. Cardiac biomarkers
    3. Exercise stress testing, oxygen consumption testing
    4. Cardiac magnetic resonance imaging
    5. Cardiac computed tomography
    6. Nuclear myocardial perfusion imaging
    7. Cardiac positron emission tomography
    8. Angiography and advanced intravascular imaging, hemodynamic and vasoreactivity testing
    9. Noninvasive vascular imaging reactivity testing
    10. Hemodynamic catheterization
    11. Electrocardiography, including 12-lead ECG and Holter
  9. Knowledge of the rationale, utility, appropriate use, and interpretation of cardiovascular testing strategies

  10. Understanding of the perioperative and peri-transplant cardiac evaluation in the surgical oncology and stem cell transplant patient

  11. Understanding of preventive strategies and risk assessments in efforts to reduce the risk of cardiovascular disease as a consequence of malignancy or its treatment

  12. Understanding of individualized treatment plans specific to the needs of the cardio-oncology patient that will best serve the patient’s long-term medical goals (survivorship care)

  13. Understanding of the principles of cardiac and cancer rehabilitation

  14. Understanding of the potential roles of pharmacists and nurses in cardio-oncology care teams

  15. Understanding of physical, psychological and social needs of adults with cardiovascular disease as a consequence of their malignancy or cancer treatment.

  16. Basic knowledge of palliative care in cancer patients with cardiovascular diseases and toxicities

CO = cardio-oncology; ECG = electrocardiogram.