When should left ventricular function be assessed in patients receiving doxorubicin?

• A. Only before therapy
• B. Only during therapy
• C. Only after therapy
• D. Before, during, and after therapy

Answer: (D)

Doxorubicin can damage the heart in a dose-dependent way and may cause subtle changes in left ventricular function before any symptoms appear. Starting with a baseline measurement gives a reference point to detect any subsequent decline. Monitoring during therapy is crucial because early, subclinical changes can be identified and addressed—this may involve adjusting the chemotherapy plan or implementing cardioprotective strategies before serious heart failure develops. Cardiac dysfunction can also emerge after therapy ends, even if everything looked normal during treatment, so a post-therapy assessment is necessary to catch late-onset cardiomyopathy and manage it promptly. For these reasons, evaluating left ventricular function before, during, and after doxorubicin therapy provides the safest, most effective approach to minimize cardiac risk while allowing effective cancer treatment.