Cancer survival reveals hidden heart care crisis

South Africa is facing a steady rise in cancer diagnoses, with more than 100 000 new cases reported each year. An ageing population and lifestyle changes are driving much of the increase, but the knock-on effects are placing a strain on an already pressured health care system. Less visible, however, is another problem quietly emerging alongside the cancer burden – the country’s acute shortage of cardio-oncologists.

These specialists deal with the complex intersection between cancer treatment and heart health – an area that is becoming increasingly important as survival rates improve. Ideally, cancer patients should undergo cardiovascular assessment before beginning chemotherapy and be carefully monitored afterwards. Yet South Africa’s ability to provide this care is constrained due to gaps in the system.

Currently, the country has only a single dedicated cardio-oncology centre, while the number of specialists trained to deal with the cardiac complications of cancer treatment is small. India, with its globally recognised expertise in cardiology and oncology, is well-placed to help close this gap. The country has built a reputation for medical innovation and training.

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Dr Trishun Singh, founding president of the Cardio-Oncology Society of Southern Africa and head of the Cardio-Oncology Centre at Netcare Umhlanga Hospital in Durban, has raised concerns about theshortage of specialists and its implications for patient care. At present, he is the country’s only practising cardio-oncologist – a stark reflection of the underdevelopment of this speciality in South Africa. While chemotherapy and radiation therapy have improved cancer survival rates dramatically, they can also damage the heart and circulatory system.

For many patients, the effects do not appear immediately. Some develop cardiovascular disease years after completing treatment, while others enter cancer treatment already living with underlying heart conditions.

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