The impact of comorbidity on cancer and its treatment

open access

Box 1.

Strategies to Address Comorbidity Among Cancer Patients

• Improving the evidence base from which to make cancer treatment decisions for those with comorbidity
• Improving the measurement of comorbidity among cancer patients
• Improving integration and coordination of care
• Preventing the occurrence of new comorbidities and limiting exacerbations of existing conditions
• Developing better tools for clinicians
• Facilitating skill development for clinicians
• Building research collaborations

Preventing the Occurrence of New Comorbidities and Limiting Exacerbations of Existing Conditions

New comorbidities can emerge during or after cancer treatment, and cancer treatment can exacerbate underlying conditions. To date, most research has focused on the management of comorbid conditions among cancer survivors,[181, 182] whereas there is very little about the impact of careful management of comorbidity and polypharmacy in the active treatment phase. For example, to our knowledge, no study has investigated ideal glycemic control for diabetic patients undergoing chemotherapy. Furthermore, research has shown that polypharmacy and adverse drug reactions are important causes of unplanned hospitalization and higher toxicity rates,[135-138] yet the studies that have been carried out to date are small and usually single-institution studies or small series. There remains a substantial gap in the evidence base regarding the frequency, severity, and impact of drug-drug interactions and regarding whether intervention to reduce polypharmacy among cancer patients receiving noncancer medications and chemotherapy would be helpful.[132, 138, 183-186].....