Medical Oncologist
Before you start
Why You Need an ECHO and ECG — Before Certain Cancer Drugs
If your oncologist has asked for an echocardiogram and ECG, it is because the drug you are about to start can affect heart function. These tests take a picture of your heart before treatment so any change later can be caught and managed early.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed August 2026
- Not everyone needs them — Heart tests are requested for specific drugs, not for all cancer treatment. Your oncologist will tell you which applies to you.
- A baseline, not a diagnosis — The tests are not looking for a heart problem right now. They record where you start, so any future change is measurable.
- Both tests are non-invasive — No injections, no catheters. An ECG takes a few minutes; an ECHO is an ultrasound scan of the heart.
- Results shape your treatment plan — If your heart is under strain before treatment begins, your oncologist may adjust the dose or choice of drug before starting.
17+
Cancer Specialists
on Panel
on Panel
96.9%
Breast Cancer
Survival Rate*
Survival Rate*
15,000+
Patients
Treated
Treated
4.8★
Google Rating
(800+ reviews)
(800+ reviews)
If your cancer treatment includes certain drugs — particularly those that target HER2 or belong to the anthracycline group — your oncologist will ask for an ECHO and ECG before you start. These tests record how your heart is working now, so any change during treatment can be detected and acted on early.
Which drugs require heart tests before treatment?
Anthracyclines — a group of chemotherapy drugs that includes doxorubicin and epirubicin — are known to affect the heart muscle in a proportion of patients. Your oncologist will request an ECHO before treatment begins if your regimen includes one of these.
HER2-targeted therapies also carry a risk of affecting heart function. Because these drugs are often given for many months, monitoring the heart before and during treatment is part of the standard NCCN and ASCO approach.
Some targeted therapies and certain supportive medicines can affect the heart's electrical signals rather than its pumping strength. An ECG picks up those changes, which is why it is often ordered alongside the ECHO.
If you are not sure why your oncologist has requested these tests, ask. Knowing which drug class is involved helps you understand what is being monitored and for how long.
What does an ECHO measure, and why does the ECG matter too?
An ECHO — short for echocardiogram — is an ultrasound scan of the heart. It measures your ejection fraction, which is how well your heart pumps blood out with each beat. This is the number your oncology team watches across your treatment.
An ECG — electrocardiogram — records the electrical signals that make your heart beat in a regular rhythm. Some cancer drugs can affect the interval between those signals, which is something an ECG can detect before it causes symptoms.
Together, these two tests give your team a complete picture of both the mechanical strength and the electrical stability of your heart before any drug touches it.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
You do not have to work this out alone
A 45-minute consultation with a specialist who treats this every week.
What happens at each heart test, step by step?
Receive your written referral
Your oncologist issues referrals for both tests. Check at this point whether the ECG can be done at your oncology centre and whether the ECHO needs to be booked at a separate cardiology or imaging facility.
Book both appointments as soon as possible
Treatment cannot start until both results are back and reviewed. Book immediately after receiving the referral. If there is a long wait, tell your oncology team — they may know a faster facility.
The ECG — a brief, painless recording
Electrodes are placed on your chest, arms and legs. You lie still for a few minutes while the machine records your heart's electrical activity. There is no current and no discomfort. Wear a top that is easy to open at the front.
The ECHO — an ultrasound scan of your heart
A sonographer applies gel to your chest and moves a small probe across it — the same technique used for an abdominal scan. You may be asked to hold your breath briefly at certain points. Wear loose, comfortable clothing.
Wait for the report to reach your oncologist
The ECHO report is usually prepared by a cardiologist or cardiac radiologist and sent directly to your oncology team. Ask your team when to expect it so you are not waiting without a timeline.
Attend your pre-treatment review
Your oncologist goes through both results before confirming your start date. If a result needs clarification or shows something to address first, they will explain what that means for your plan before any decision is made.
Did you know?
Heart function changes caused by some cancer drugs can be reversible if they are identified at an early stage, according to ASCO and ACC joint guidance on cardiovascular toxicity in cancer patients.
Without a baseline measurement taken before the first dose, it is impossible to tell later whether a finding is new or pre-existing. That single comparison is the entire reason the test is ordered before treatment begins.
Source: ASCO/ACC Expert Consensus Statement on Cardiovascular Toxicity in Cancer Patients
Explore 119 more Targeted Therapy Basics, Testing & Your Cancer Type topics
Before You Start - Preparation & Baseline
- 25 Questions to Ask Your Oncologist Before Starting Targeted Therapy
- Before You Start Targeted Therapy: The Complete Preparation Checklist
- Dental Check-Up Before Cancer Treatment: Why It Matters
- Financial Planning Before Starting Long-Term Targeted Therapy
- How Long After Surgery Can You Start Targeted Therapy?
- How to Store Your Targeted Therapy Tablets Correctly
- Setting Up a Dosing Routine You Won't Forget
- Should Targeted Therapy Be Taken With Food or on an Empty Stomach?
- Vaccinations Before and During Cancer Treatment
- What to Expect in Your First Month on Targeted Therapy
- Which Baseline Tests Are Done Before Starting a TKI?
- Which of Your Existing Medicines Must Stop Before Targeted Therapy
- Why You Need an ECHO and ECG Before Certain Cancer Drugs
Biomarker & Molecular Testing
- Can Mutation Testing Be Done on an Old Biopsy Block or Slides?
- Cost of NGS and Mutation Testing in India: 2026 Price Guide
- Do I Need Genetic Testing Before Starting Targeted Therapy?
- Germline vs Somatic Testing: The Difference Nobody Explains Properly
- Getting a Second Opinion on Your Genomic Report
- How Long Do Mutation Test Results Take in India? Realistic Timelines
- How to Read Your Molecular Pathology Report, Line by Line
- IHC, FISH, PCR or NGS: Which Mutation Test Is Right for Your Cancer?
- Is Mutation Testing Worth It If I Can't Afford the Drug?
- Liquid Biopsy vs Tissue Biopsy: Which Test Do You Need?
- My Report Says a Mutation Is 'Actionable': What Does That Mean?
- No Mutation Found in My Report: What Are My Options Now?
- Should I Start Chemotherapy While Waiting for Mutation Results?
- Should You Repeat Molecular Testing After Your Cancer Progresses?
- Single-Gene Test or Full Panel? How to Choose Without Wasting Money
- What Are PD-L1, TMB and MSI, and Do They Affect Targeted Therapy?
- What Does 'Variant of Uncertain Significance' (VUS) Mean?
- What Happens If There Isn't Enough Tissue for Mutation Testing?
- What Is NGS (Next-Generation Sequencing) Testing in Cancer?
- What Is a Molecular Tumour Board and Why Should You Want One?
- Which Cancers Should Always Be Tested for Mutations? A Checklist
- ctDNA and MRD Testing: Tracking Cancer Through a Blood Test
Cancer-Type Specific Targeted Therapy
- CML Treatment with TKIs: Living a Normal Life Span
- Cancer of Unknown Primary: Can Molecular Testing Help?
- GIST Treatment: Why This Cancer Changed Targeted Therapy Forever
- Targeted Therapy for Bile Duct Cancer (Cholangiocarcinoma)
- Targeted Therapy for Bladder and Urothelial Cancer
- Targeted Therapy for Brain Tumours and Glioma
- Targeted Therapy for Breast Cancer: HER2, HR+ and Triple Negative
- Targeted Therapy for CLL and Lymphoma
- Targeted Therapy for Cervical and Endometrial Cancer
- Targeted Therapy for Childhood Cancers
- Targeted Therapy for Colorectal Cancer: RAS, BRAF and HER2
- Targeted Therapy for Head and Neck Cancer
- Targeted Therapy for Kidney Cancer (RCC)
- Targeted Therapy for Liver Cancer (HCC)
- Targeted Therapy for Lung Cancer: Every Mutation and Drug Explained
- Targeted Therapy for Melanoma: BRAF and MEK Inhibitors
- Targeted Therapy for Multiple Myeloma
- Targeted Therapy for Neuroendocrine Tumours
- Targeted Therapy for Ovarian Cancer: PARP Inhibitors and Beyond
- Targeted Therapy for Pancreatic Cancer: Limited but Real Options
- Targeted Therapy for Prostate Cancer
- Targeted Therapy for Sarcoma
- Targeted Therapy for Stomach and Gastroesophageal Cancer
- Targeted Therapy for Thyroid Cancer
- Targeted Therapy in AML: Beyond Standard Chemotherapy
- Tumour-Agnostic Drugs: When the Mutation Matters More Than the Organ
Foundations & How Targeted Therapy Works
- Adjuvant and Neoadjuvant Targeted Therapy: Treatment Before or After Surgery
- Antibody-Drug Conjugates (ADCs): The Smart Bombs of Cancer Treatment
- Biosimilars and Generic Targeted Therapy Drugs: What They Are
- Can Targeted Therapy Be Combined with Chemotherapy or Radiation?
- Can Targeted Therapy Cure Cancer? An Honest Answer
- First-Line, Second-Line and Beyond: How Treatment Lines Work
- How Doctors Decide Between Chemo, Immunotherapy and Targeted Therapy
- How Does Targeted Therapy Actually Work? Explained Without Jargon
- How Long Does Targeted Therapy Take to Start Working?
- Is Targeted Therapy Painful? What the Treatment Actually Feels Like
- Is Targeted Therapy a Type of Chemotherapy? Clearing Up the Confusion
- Oral Tablets vs IV Infusion Targeted Therapy: What's the Difference?
- Precision Oncology vs Personalised Medicine: Are They the Same Thing?
- Targeted Therapy Success Rates: What the Numbers Really Mean
- Targeted Therapy for Stage 4 Cancer: What You Can Realistically Expect
- Targeted Therapy vs Chemotherapy: 12 Differences That Actually Matter
- Targeted Therapy vs Immunotherapy: Which One Is Right for You?
- The 8 Main Types of Targeted Therapy Drugs (With Examples)
- What Do Cancer Drug Endings Like -nib, -mab and -tinib Mean?
- What Is Targeted Therapy for Cancer? A Complete Patient Guide
- Which Cancers Can Be Treated with Targeted Therapy? Full List
- Why Didn't My Doctor Recommend Targeted Therapy for Me?
Mutation & Target-Specific Pages
- ALK-Positive Lung Cancer: Drugs, Response and What Comes Next
- Antiangiogenic Drugs (VEGF Inhibitors): How Starving a Tumour Works
- BCR-ABL and the Philadelphia Chromosome in CML
- BRAF V600E Mutation: Targeted Therapy Across Multiple Cancers
- BRCA vs HRD Testing: Which One Determines PARP Inhibitor Eligibility?
- BRCA1 and BRCA2 Mutations in Cancer Treatment: PARP Inhibitors
- BTK Inhibitors in CLL and Lymphoma
- CD20, CD38 and Other Antibody Targets in Blood Cancers
- CDK4/6 Inhibitors in Hormone-Positive Breast Cancer
- Co-Mutations: When You Have Two Mutations at Once
- EGFR Exon 20 Insertion: Why It's Different and Harder to Treat
- EGFR Mutation in Lung Cancer: Complete Patient Guide
- ESR1 Mutation: Why Your Hormone Therapy Stopped Working
- FGFR Alterations in Bladder and Bile Duct Cancer
- FLT3 Mutation in AML: What It Means for Your Prognosis
- HER2 Mutation in Lung and Gastric Cancer
- HER2-Low Breast Cancer: A New Category That Changes Treatment
- HER2-Positive Breast Cancer: The Full Targeted Therapy Roadmap
- IDH1 and IDH2 Mutations in Glioma, AML and Bile Duct Cancer
- KIT and PDGFRA Mutations in GIST
- KRAS G12C Mutation: The Target That Was Undruggable for 40 Years
- KRAS Mutation but Not G12C: What Are My Options?
- MET Exon 14 Skipping and MET Amplification Explained
- MSI-High and Mismatch Repair Deficiency: Testing and Treatment
- NRG1, MET, RET and Other Rare Fusions: Where to Get Tested
- NTRK Fusion: One Drug for Many Different Cancers
- Osimertinib: What to Expect, Side Effects and How Long It Works
- PALB2, ATM and Other BRCA-Like Genes: Do They Get the Same Drugs?
- PIK3CA Mutation in Breast Cancer: Alpelisib and What to Expect
- PSMA and AR-Targeted Therapy in Prostate Cancer
- RET Fusion Cancer: Lung, Thyroid and Beyond
- ROS1-Positive Cancer: A Rare Mutation with Excellent Options
- TP53 Mutation: Why There's Still No Targeted Drug for It
- Understanding Variant Allele Frequency (VAF) in Your Report
- What If My Mutation Has No Approved Drug Yet?
- mTOR Inhibitors in Cancer: Everolimus and Temsirolimus
Next step
Still not sure what applies to you?
Send your reports across and a senior medical oncologist will go through what they mean, what is known, and what the options actually are.
Common questions
Frequently asked questions
Do I need to fast or prepare anything before an ECHO or ECG?
For a standard resting ECHO and ECG, no fasting is required. You can eat normally and take your usual medicines before you go. Wear clothing that is easy to open at the chest — you will need skin contact for both tests. If your referral specifies a stress ECHO or any variation involving exercise, fasting instructions will be included in the letter. When in doubt, call the facility the day before to confirm what is expected.
What if my ECHO result shows my heart is not strong enough to start treatment?
Your oncologist will explain what the result means and what the options are. A result that is lower than expected does not automatically mean treatment cannot happen. It may mean the drug choice is adjusted, a cardioprotective medicine is added, or a cardiologist reviews you first. These decisions are made jointly by your oncology and cardiology teams, and you will be part of that conversation. The test exists so this can be addressed before the first dose — not as a barrier, but as information.
Will I need heart tests during treatment too, or only before I start?
For drugs with a known cardiac risk, your team will repeat the ECHO at intervals during treatment. The schedule depends on the drug, the cumulative dose, and how your results are tracking. NCCN and ASCO guidance recommends ongoing monitoring for anthracyclines and HER2-targeted therapies. Your team will tell you the plan at the start. If you notice new breathlessness, unusual fatigue, or swelling in your legs at any point, tell your team immediately rather than waiting for the next planned test.
Can I have these tests done at a CION centre?
ECG is often available within CION centres as part of the pre-treatment assessment. The ECHO is typically coordinated with a partner cardiology or imaging facility. Your oncology team at CION will arrange the referral and tell you where to go for each test. If you already see a cardiologist, let your CION team know — in some cases your existing cardiac records can supplement what is needed and avoid duplication.
I already have a heart condition. Does that mean I cannot have certain cancer drugs?
Not necessarily, but it changes the conversation. A pre-existing heart condition means your cardiologist should be involved in the decision alongside your oncologist. For some drugs, the benefit of treatment still outweighs the cardiac risk even with a known heart condition, particularly if it is well controlled. For others, an alternative drug may be preferred. This is exactly the situation the baseline ECHO is designed to inform — it gives both teams the current picture they need to make a considered recommendation for you specifically.