A woman with breast cancer is receiving doxorubicin and reports fatigue, shortness of breath, and swollen ankles. What is the most appropriate action?

• A. Reassure and monitor symptoms
• B. Explain that these symptoms could indicate cardiotoxicity, and she should promptly contact her oncology team to report these side effects
• C. Advise to seek GP involvement
• D. Advise to stop chemotherapy immediately without consulting oncology

Answer: (B)

Doxorubicin can cause cardiotoxicity, meaning damage to the heart muscles that can lead to heart failure. Fatigue, shortness of breath, and ankle swelling in someone receiving this drug may be early signs of that complication. The best approach is to tell her that these symptoms could indicate cardiotoxicity and she should promptly contact her oncology team to report them for urgent assessment. This allows timely evaluation (often with heart imaging like an echocardiogram and other tests), and decisions about modifying or holding chemotherapy can be made by the oncology team. Reassuring and monitoring alone could delay detection and management, involving a GP isn’t the immediate priority in this cancer-care context, and stopping chemotherapy without oncology input isn’t appropriate—the oncology team should determine the safest plan based on the heart assessment.