The impact of comorbidity on cancer and its treatment

open access

Introduction

Chronic diseases are generally more common among the elderly than younger adults, and many of these are not life threatening in the short term. Consequently, many people live with, rather than die from, chronic health conditions. Cancer itself is a chronic disease with long-term consequences for health and quality of life and is more prevalent among older people. Comorbidity among cancer patients is therefore common. Data from Medicare beneficiaries in the United States (ie, for patients aged 65 years or older) indicate that four of ten patients with cancer have at least one other chronic condition recorded, and 15% have two or more, with the most common chronic conditions including cardiovascular illness, obesity and metabolic illness, mental health problems, and musculoskeletal conditions.[1] The coexistence of cancer and other chronic conditions has substantial implications for treatment decisions and treatment outcomes for both cancer and chronic disease.[2-6] Most guidelines of cancer treatment do not consider the complex interrelations between cancer and comorbidity and instead adopt a “single-disease” approach to management. With increasing subspecialization in medicine and surgery, providers are often not skilled in managing the wide spectrum of different diseases that may be present in individual patients with cancer, potentially negatively impacting patient outcomes.[6].....