When Cancer Is Not Your Only Health Concern

Approved by the Cancer.Net Editorial Board, 09/2015

Many people with cancer also have other health problems, such as:

  • Diabetes

  • Heart disease

  • High blood pressure

  • Depression and anxiety

  • Lung disease

  • Chronic kidney disease

Medical conditions you experience in addition to cancer are often called co-existing conditions. When you are coping with the challenges of cancer, it can be easy to ignore co-existing conditions. However, it is important to talk about your overall health with your cancer care team. The way you manage other chronic health issues often influences the success of your cancer treatment plan. 

Risks for people with co-existing conditions

It is important to understand how a co-existing condition may affect cancer treatment and your body’s reaction to it. In general, the risks include:

  • Interactions between cancer drugs and medications for another health problem

  • Worsening of a chronic condition by the cancer or cancer treatment

  • Interruptions or modifications to cancer treatment due to health problems caused by another medical condition

  • A slower recovery after cancer treatment because of a co-existing condition

Your cancer care team will work with you and your other health care providers to minimize these risks.

Managing co-existing conditions during cancer treatment

  • Diabetes. If you have diabetes, you need to closely monitor and control your blood glucose (sugar) levels during cancer treatment. Radiation therapy and some types of chemotherapy may cause blood glucose levels to rise. Lack of physical activity, stress, and treatment side effects, like nausea and vomiting, also affect blood glucose levels. Your doctor may recommend a drug called dexamethasone (multiple brand names). It helps manage nausea and reduce the risk of developing high blood sugar levels.

    To help manage diabetes, your doctor may recommend taking low-sugar food supplements and anti-nausea medications. Your doctor may also recommend using fast-acting insulin as a supplement to your normal insulin during cancer treatment. In addition, your doctor may recommend recording your blood glucose levels so they can be reviewed at your clinic visits. Keeping your blood glucose levels under control will make sure you are able to stick to your cancer treatment schedule.

  • Heart disease. Your doctor will test your heart function and blood pressure regularly to manage your heart condition. Some cancer drugs can make heart problems worse, increase the risk of congestive heart failure, or increase blood pressure. Congestive heart failure occurs when the heart muscle is weakened and has a harder time pumping blood around the body. These medications include:

    • Drugs from the anthracycline family, such as daunorubicin (Cerubidine, Rubidomycin), doxorubicin (Adriamycin), epirubicin (Ellence), and idarubicin (Idamycin)

    • Trastuzumab (Herceptin)

    • Cyclophosphamide (Neosar)

    Other cancer drugs, such as bevacizumab (Avastin), sorafenib (Nexavar), and sunitinib (Sutent) can cause blood pressure to rise. This may require a change in blood pressure medication. Some medications taken for heart conditions may also interact with certain types of chemotherapy. The risk of high blood pressure lowers once a person stops taking these drugs.

    Receiving radiation therapy near the heart or combining chemotherapy and radiation therapy has the potential to cause heart problems. A cardiologist may prescribe medications to help protect your heart during cancer treatment. A cardiologist is a doctor who specializes in treating heart conditions. These drugs include angiotensin-converting enzyme (ACE) inhibitors or beta-blockers.

    It is important for patients, their oncologists, and their cardiologists to work together to find a balance in managing heat conditions while treating cancer.

  • Depression and anxiety. Depression and anxiety often follow a cancer diagnosis and may interfere with the treatment decision-making process. These conditions also make it more difficult to follow through with activities like taking medication and having important tests. Sometimes, people don’t seek family and social support during treatment due to depression and anxiety.

    If you are taking medications to manage depression or anxiety, your doctor may ask you to change or temporarily stop them. This is because they may interact with specific cancer treatments or medications to manage side effects. One example is women with breast cancer whose treatment plan includes the hormone therapy tamoxifen (Nolvadex, Soltamox). If a woman is taking an antidepressant medication, she should talk with her doctor before starting tamoxifen. There are potential interactions between tamoxifen and certain antidepressants. Individual or group counseling and cancer support groups can help people with cancer manage depression and anxiety during this time.

  • Lung disease. Specific types of chemotherapy can affect lung function. People with a lung condition like emphysema or chronic obstructive pulmonary disease should talk with a doctor before starting treatment.

  • Kidney disease. People with kidney failure or decreased kidney function often have difficulty processing some types of chemotherapy. This can increase the risk of developing additional kidney problems or other health issues. People having dialysis need to coordinate with their oncologist. Dialysis a procedure that cleans the blood when the kidneys cannot. Besides filtering waste, dialysis may also filter chemotherapy out of the body.  

  • Dental and oral health problems. If you have ongoing dental or oral health problems, tell your dentist and dental hygienist about your cancer treatment. Make sure your oncologist is aware of the specific issues as well. Some chemotherapies may increase your risk of infection or bleeding and can cause sores in the mouth or throat. Radiation treatment to the head and neck can also cause mouth sores and increase tooth decay. In addition, some drugs used to treat people with cancer can cause dental health problems. For instance, drugs called bisphosphonates that help strengthen bones can increase the risk of a rare type of jaw disease.

    If possible, try to have dental work done before treatment begins or schedule it after completing treatment. Depending on your dental and oral health, your doctor may want you to see an oncologic dentist before starting treatment. An oncologic dentist is a dentist experienced in treating people with cancer. Learn more about dental and oral health.

Preventing drug interactions

If you are taking medications to manage a co-existing condition, your doctor may ask you to temporarily stop taking them. This is because some drugs may react with cancer treatments or medications to manage side effects. Sometimes the side effects of cancer treatment can make it unsafe to take specific medications. If you are unsure about which medications you should be taking, talk with your doctor or pharmacist.

Talking with your doctor

When you meet with your doctor to discuss cancer treatment options, bring your personal medical record. This information will help the doctor better coordinate your care and minimize the risk of complications. This record should outline your complete medical history, including:

  • Any chronic conditions you may have

  • The medications you are taking, including the dosage, how often you take the medication, and any side effects you have experienced

  • Drug allergies, including what you experienced when you took a medication you are allergic to

  • Previous surgeries or medical procedures

  • Medical tests and results

  • Names of your other doctors, including contact information

It is also important to ask questions to learn more about how your chronic conditions may affect your cancer and cancer treatment. Consider asking the following questions:

  • What are my treatment options?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What treatment plan do you recommend and why?

  • How will this treatment affect my chronic condition(s)? Will it make the condition(s) worse?

  • What is the best way for me to manage my chronic condition(s) during treatment?

  • Will I need additional or different medications, tests, or screenings during treatment to control my chronic condition(s)?

  • How can I reduce potential side effects or health problems related to my cancer treatment?

  • How will you work with my other health care providers to share health information and manage my care?

More Information

Cancer in Older Adults: Co-Existing Conditions

Long-Term Side Effects of Cancer Treatment

Organizing Your Cancer Care

The Importance of Taking Your Medication Correctly