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Comorbidities and their Role in Cancer Treatment

The second most significant cause of death worldwide is cancer. The doctor should take extra care for patients with comorbid conditions. One of the critical elements that can impact a cancer patient’s fate is a comorbid condition; other factors include age, nutritional state, and appropriate treatment, among others.

Comorbidity

A comorbidity is a chronic ailment that co-exists with the primary disease and is an adjunct to it. Given that the majority of cancer diagnoses occur in people over the age of 50, these concomitant diseases may have already existed. Cardiovascular illnesses, such as diabetes, heart failure, chronic obstructive pulmonary disease, peripheral vascular disease, cerebrovascular disease, dementia, joint issues, liver issues, kidney issues, obesity, or hypertension, are a few examples of comorbid disorders with cancer.

Some of these co-occurring disorders have cancer risk factors in common. Comorbid illnesses can occasionally have a substantial effect on cancer treatment and recovery.

Choice of cancer treatment and its Impact on comorbidities

Different treatment methods are available depending on the kind and degree of the comorbidity. Due to a significant risk of adverse effects and complications, certain oncologists may not advise specific cancer treatments for patients with comorbid illnesses.

For instance, a chemotherapy drug may build up in the bodies of individuals with impaired kidney function and might result in toxicity that poses a life-threatening risk. So, these patients might not be suitable candidates for conventional chemotherapy and might require drug dose adjustments or drug substitutions that could have an impact on the course of treatment.

Cancer treatment outcomes and their Impact on comorbidities

Treatment results are influenced by the kind and degree of comorbidity. A patient with chronic obstructive pulmonary disease, for instance, might not be able to withstand the anaesthetic needed for thyroid cancer surgery, necessitating a tailored approach to cancer treatment.

When preparing cancer therapy for a patient with comorbid diseases, the healthcare team should consult with specialists from other fields to help improve the treatment’s results.

The kind, intensity, and quantity of the comorbidities will all have an impact on the treatment’s result.

Effects of comorbidities on survival and quality of life

Comorbidities have been shown to have a negative impact on cancer survival. That is why, the stage of cancer, the prognosis of cancer, the severity of comorbidities, and the Impact of treatment all influence a person’s cancer-specific survival.

Comorbidities can affect survival in a variety of ways. One aspect is the condition’s direct impact on mortality. Another factor is that cancer patients with comorbidities are given less intensive therapy, which reduces their chances of survival. It’s also probable that patients will have rising degrees of treatment toxicity, lowering their chances of cancer-specific survival. Comorbidities may potentially have an impact on the progression of cancer.

Cancer patients with comorbidities have a low quality of life. Their quality of life is low in general, but when they have comorbidities, it deteriorates even more since it puts pressure on the body’s physiological functioning.

Cancer treatments and their effects on the outcomes of comorbidities:

Not only do comorbidities influence the result of cancer treatment, but the opposite is also true. The outcome of comorbidities may be influenced by cancer treatment.

Cancer treatments can raise the risk of musculoskeletal, cardiovascular, and metabolic problems, as well as exacerbate existing comorbidities. These consequences are more severe in patients with preexisting comorbid diseases, which may worsen as a result of therapy side effects. To guarantee a smooth treatment and minimise complications, we must pay close attention to the management of comorbid conditions during cancer treatment.

Steps to treat comorbidities as a cancer patient

When treating individuals with comorbid diseases, there are several obstacles to overcome. We need to discover a better way to deal with these issues. Comorbidities necessitate both research and clinical treatment solutions.

The following strategies may help you achieve a better result:

Comorbidity measurement:

 In cancer patients, it’s critical to evaluate comorbidity more precisely. Because, this will help researchers better grasp the link between comorbidity and cancer outcomes.

Improved care coordination and integration:

 It is critical to provide care that extends beyond cancer and addresses all of a cancer patient’s other healthcare requirements. Hence, community-based cancer services and health information technology can help with this. Also, collaboration with primary care and the promotion of care plans can help. Therefore, to avoid worsening of physiological functions and associated comorbid diseases, focus on keeping enough nutrition for the patient.

Prevent new comorbid conditions from developing: 

It is critical to avoid the development of new comorbid conditions during or after cancer therapy. If a new comorbid illness develops, it may have a negative impact on the patient’s treatment and cancer survival.

Additional research: 

The mechanics and epidemiology of comorbidity must be assessed. We must also evaluate the impact of various care delivery approaches. Hence, improving research practices entails a number of steps. People with comorbidities should be included in clinical studies

References

Chris Pirschel. (2017, January 30). The impact of comorbidities on cancer patient care. ONS Voice. https://voice.ons.org/news-and-views/comorbidities-in-cancer-patient-care

Comorbidities and their role in cancer treatment. (2020, December 28). Onco blog. https://onco.com/blog/comorbidities-and-their-role-in-cancer-treatment/#:~:text=It’s%20not%20only%20comorbidities%20that,and%20worsen%20the%20existing%20comorbidities

Diana Sarfati. (2016, February 17). The impact of comorbidity on cancer and its treatment. ACS Jornals. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21342

Helen Fowler, Aurelien Belot, Libby Ellis, Camille Maringe, Miguel Angel Luque-Fernandez, Edmund Njeru Njagi, Neal Navani, Diana Sarfati, & Bernard Rachet. (2020, January 28). Comorbidity prevalence among cancer patients: A population-based cohort study of four cancers. BioMed Central. https://bmccancer.biomedcentral.com/articles/10.1186/s12885-019-6472-9

J Clin Oncol. (20, October). Comorbid disease and cancer: The need for more relevant conceptual models in health services research. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1853249/

Linda Lee, Winson Y. Cheung, Esther Atkinson, & Monika K. Krzyzanowska. (2010, November 22). Impact of comorbidity on chemotherapy use and outcomes in solid tumors: A systematic review | Journal of clinical oncology. ASCO Publications. https://ascopubs.org/doi/10.1200/JCO.2010.31.3049

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