Co-Existing Conditions

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2012

Key Messages

  • Co-existing conditions are health problems that a person has in addition to cancer.
  • Having a co-existing condition can increase the side effects of treatment and slow recovery time.
  • Talking with your doctor about any health problems you have can help you understand how they can affect cancer treatment.

What is different about older adults with cancer is the fact that they frequently have serious health problems, such as high blood pressure, diabetes, or depression, in addition to cancer. These co-existing conditions often influence how treatment affects a person with cancer, including:

  • Prognosis (chance of recovery)
  • Ability to deal with treatment side effects
  • Recovery from treatment

Knowing how your co-existing conditions could affect treatment and recovery is an important part of choosing treatment options.

Co-existing conditions that affect treatment and recovery

Co-existing conditions can increase an older adult’s risk of side effects from treatment and slow recovery time. When making treatment decisions, you and your doctor should consider the following conditions, as well as other conditions you may have that are not on this list:

Heart conditions. Congestive heart failure, high blood pressure, arrhythmia (irregular heartbeat), and a decrease in heart function may reduce the ability to deal with the physical effects of treatment. In addition, chemotherapy can worsen heart problems. Radiation therapy given near the heart and a combination of radiation therapy and chemotherapy can cause heart problems as well. Also, some medications that are taken for a heart condition may interact with chemotherapy.

Lung conditions. Emphysema, chronic obstructive pulmonary disease, and decreased lung function affect how well the body handles certain medications.

Kidney failure or decreased kidney function. As a person ages, some types of chemotherapy are more difficult for the kidneys to process. This can increase the risk of kidney problems and may prevent some older adults with cancer from receiving intense treatment.

Stomach problems. Difficulty absorbing nutrients from food can be made worse by chemotherapy, especially if the drugs cause nausea, vomiting, or diarrhea.

Poor nutrition. Some older adults may not be able to eat easily because of tooth loss, new dentures, or certain medications. These factors may cause a decreased appetite or weight loss. The doctor or a registered dietitian (RD) can provide more information on how to make sure an older adult is eating enough during cancer treatment.

Smoking. Smoking increases the risk of developing lung problems after surgery and may increase recovery time. It may also make chemotherapy less effective and leads to shorter survival and poorer quality of life. Learn more about quitting smoking.

Alcoholism. A dependency on alcohol or other drugs can interfere with the ability to make treatment decisions and follow through with day-to-day responsibilities, including taking medication and having important screenings or tests. In addition, alcohol or drug use often increases recovery time.

Anemia. Anemia may worsen during chemotherapy. Although anemia may not change the cancer treatment an older adult receives, it can cause delays if a longer time to recover between treatments is needed. Patients with anemia may need medications or blood transfusions.

Depression and anxiety. Depression and anxiety can be common for older adults, but they are not a normal part of aging. Depression lowers a patient’s quality of life. The loss of a spouse or family members, or friends moving away, can make some older adults feel alone, adding to feelings of depression. Depression, anxiety, and other mental health issues may interfere with the ability to participate in treatment decision-making. Depression and anxiety are treatable, but some antidepressants and anti-anxiety medications could interact with chemotherapy.

Pain and immobility. Older adults often have difficulty with pain and immobility (not being able to move around) caused by conditions such as arthritis. Not being able to move around easily or at all can affect an older adult’s ability to get to doctors’ appointments or receive certain treatments. In addition, pain and immobility may increase the risk of side effects.

Memory loss and mental confusion. Older adults may experience memory loss, confusion, or a change in their thought process. In addition, specific cancer drugs can cause mental fogginess that is sometimes referred to as Attention, Thinking or Memory Problems (ATMP). These issues may make it harder to keep track of medications and appointments.

Talking with your doctor

Before making decisions about cancer treatment, talk with your doctor about your co-existing conditions, including:

  • Medications you are currently taking and any side effects from these medications
  • Your medical history, including any co-existing health problems and how they affect your everyday functioning
  • The names and phone numbers of any other doctors who are treating you

Learn more about the common side effects of cancer and how to manage them.

 

More Information

Chronic Conditions: When Cancer Is Not Your Only Health Concern

Nutrition Recommendations During and After Treatment

Cancer in Older Adults