COMPASS is exploring the connection between cancer and cardiovascular health, working towards earlier detection, personalised care and better long-term outcomes for cancer patients and survivors.

Cancer and cardiovascular disease are two of the major health challenges facing our society. But although they are often considered separately, the connection between them is becoming increasingly important.

As advances in diagnosis and treatment enable more people to survive cancer and live longer, protecting their health during and after treatment has become an essential part of cancer care. This includes paying attention to the cardiovascular system.

This challenge is at the heart of the COMPASS project. By bringing together expertise from oncology, cardiology, medical imaging, diagnostics, artificial intelligence (AI), behavioural sciences and other fields, all COMPASS partners are working towards a more integrated approach to care throughout the cancer journey.

But why are cancer and cardiovascular health connected in the first place?

When cancer treatment affects the cardiovascular system

Some people already have cardiovascular risk factors or conditions when they receive a cancer diagnosis. At the same time, certain cancer treatments can have unintended effects on the heart and blood vessels. This is a challenge known broadly as cardiotoxicity or cardiovascular toxicity, and its prevention, detection and management have become an important part of the growing field of cardio-oncology. The European Society of Cardiology (ESC), for example, has developed specific guidelines addressing cardiovascular health in patients with cancer.

Different cancer therapies can be associated with different cardiovascular complications. A review published in Frontiers in Cardiovascular Medicine, for example, describes potential cardiovascular effects associated with several types of chemotherapy, targeted therapies, immunotherapies and radiotherapy. These can range from changes in heart function and blood pressure to vascular complications, depending on the treatment and the individual patient.

Importantly, this does not mean that every person receiving cancer treatment will develop cardiovascular problems. Individual risk can vary depending on a range of patient- and treatment-related factors.

Understanding these differences is therefore essential. Rather than applying the same approach to everyone, healthcare professionals need better ways to identify who is at risk, when cardiovascular changes are occurring and what type of monitoring or intervention each person may need.

Detecting cardiovascular problems earlier

Another challenge is that cardiovascular effects do not always appear immediately. They may emerge during cancer treatment, but some can develop months or even years later. In some cases, changes may already be taking place before noticeable symptoms appear. This makes risk prediction and early detection particularly important.

COMPASS is investigating how different types of information can help build a more complete picture of each patient’s cardiovascular health. This includes advanced medical imaging, molecular and physiological biomarkers, genetic and other clinical information, as well as data collected through wearable technologies.

AI will also play an important role in bringing these different sources of information together. The project aims to develop predictive models and clinical decision-support tools that can help healthcare professionals identify cardiovascular risks and support more personalised decisions about monitoring and treatment.

From cancer treatment to long-term survivorship

As more people live longer after cancer, understanding how best to protect their cardiovascular health in the long term is becoming increasingly important. Cancer survivors are a diverse population, and their cardiovascular health and monitoring needs may differ considerably.

This is where the COMPASS approach becomes particularly important. Long-term cardiovascular follow-up cannot simply mean monitoring every cancer survivor in the same way. The project aims to generate evidence to better understand who may benefit from continued cardiovascular surveillance, what that follow-up should involve and how care can be adapted to different levels of risk.

Providing this kind of care also requires greater coordination across different areas of healthcare. ESMO consensus recommendations highlight the importance of interdisciplinary collaboration throughout cancer care. Through multidisciplinary care networks and more integrated pathways, COMPASS aims to help bridge the traditional separation between cardiology and oncology and promote a more coordinated approach centred on each patient.

Ultimately, successful cancer care is not only about treating cancer. It is also about protecting patients’ cardiovascular health, quality of life and long-term well-being. That is the connection COMPASS is working to better understand and to better manage.