When Cancer is Not Your Only Health Concern

Approved by the Cancer.Net Editorial Board, 08/2021

Many people have health conditions in addition to cancer. Any health concern that you have at the same time as cancer can be called a co-existing condition, a chronic condition, or a comorbidity. One in 4 adults have at least 2 chronic conditions and they are even more frequent in adults who are aged 65 and older.

Some common types of co-existing conditions are:

  • High blood pressure

  • Heart disease

  • Lung disease

  • Diabetes

  • Kidney disease

  • Arthritis

It can be easy to ignore other health conditions when you have cancer. For example, taking care of your high blood pressure or diabetes can seem less important than getting cancer treatment. But the success of your cancer treatment is partly based on your general health and sometimes cancer treatment can make other conditions worse. That is why it is important that your other health conditions are treated, managed, and monitored.

How can co-existing conditions affect cancer treatment?

It is important to know how your chronic health problem(s) can affect cancer treatment. Some of the risks can include:

  • Unwanted reactions between your cancer drugs and other medications, called drug interactions.

  • Cancer or its treatment making your chronic health problems worse. This could make it harder to finish cancer treatment as planned.

  • Slower recovery from cancer treatment because of your other health problems.

You should talk with your cancer care team about any other health problems you have and any medications you take for them. Your cancer care team will work with you to lower these risks. For example, your doctor might ask you to stop taking or switch a current medication during cancer treatment. This is because some drugs can cause unwanted results when they interact with cancer treatments or medicine prescribed to relieve side effects.

How are co-existing conditions managed during cancer treatment?

Common health problems and how to manage them during cancer treatment are discussed below.

Heart disease and blood pressure. Some cancer treatments can affect the heart or blood pressure. This is often a concern for older adults, who may already have a higher risk of these conditions.

Ask your health care team if your cancer treatment or any of your new medications might affect your heart or blood pressure. Work with your oncologist, which is a cancer specialist, and your cardiologist, which is a heart specialist, to adjust your medications, if needed, and protect your heart during cancer treatment. Your doctor may also test your heart function and blood pressure regularly during treatment. Learn more about how to manage high blood pressure and heart disease during cancer treatment.

Lung disease. Some types of chemotherapy may increase your risk of inflammation of the lungs, cough, or shortness of breath. Tell your health care team if you have a chronic lung condition before starting cancer treatment. This includes asthma, emphysema, or chronic obstructive pulmonary disease (COPD).

Diabetes. If you have diabetes, you need to monitor your blood glucose, or blood sugar, levels closely during cancer treatment. Some chemotherapy and medications used for side effects, such as steroids, can raise these levels. Levels might also go up because you are less physically active or under stress. Side effects, like nausea and vomiting, or changes in how your eat will also affect your blood sugar.

Work with your health care team to make a plan for monitoring and managing blood sugar levels during treatment if you have diabetes. This may mean checking blood sugar more often or adjusting the dose of your diabetes medication. Learn more about managing diabetes during cancer treatment.

Kidney disease. "Kidney disease" can refer to several different illnesses that affect your kidneys. While chronic kidney problems are much more common in older adults, they can happen at any age. Certain drugs, including some types of chemotherapy, can affect your kidneys and raise your risk of developing kidney problems or making existing kidney problems worse. If you have a history of kidney problems, you will probably have regular blood tests done to check how your kidneys are working. How well your kidneys work might determine the type of chemotherapy you can have, or how often it will be given.

Anxiety and depression. Sadness and worry are normal feelings throughout life, and many people experience brief times of anxiety or depression. But when such feelings are ongoing and interfere with daily life, they are considered chronic conditions. Anxiety and depression are common chronic conditions for people with cancer. Some people may develop anxiety and/or depression after their cancer diagnosis, and some people have these conditions before their diagnosis.

Depression and anxiety can make it difficult to:

  • Make decisions about treatment

  • Take medication on time or have needed tests

  • Ask for or accept support from your family and other loved ones

Anxiety or depression can happen at any age. Both can be treated. You may take medication, work with a therapist, or use a combination of these treatments. It is important to let your health care team know how you are managing your anxiety or depression. Like other medications, there is a chance the medication you are taking to treat your anxiety and depression might interfere with your cancer treatment. If that's the case, your health care team will work with you to find an another medication or treatment for your anxiety and/or depression.

Tell your health care team if you are experiencing or have a history of depression and anxiety. Ask them before stopping any medications for these conditions. There are many resources that your health care team can tell you about. These include cancer support groups, assistance from a social worker, and/or support from family and friends.

Pain and problems moving around. Existing problems with pain, such as arthritis or a previous injury, can cause problems during cancer treatment. For example, these problems can make it harder to do your daily activities, get helpful exercise, or get to your medical appointments. They can also raise the risk of some side effects.

Physical activity is important for your overall health, especially for people with cancer. Your health care team will want you to be as active as you can during and after your treatment. Let them know about any existing problems you might have that can cause you pain. It may help to talk with a specialist in this area, such as a physical or occupational therapist, a cancer rehabilitation expert, or an oncology exercise specialist.

Memory loss and mental confusion. Adults over the age of 65 are especially at risk of having existing problems with memory loss and mental confusion. Cancer treatment could make these problems worse. Tell your health care team if you are experiencing these symptoms.

Problems with your mouth and teeth. Tell your dentist and dental hygienist about all of your cancer treatments. This is especially important if you have any problems with your mouth or teeth. Also, make sure your oncologist knows about these problems.

If possible, try to have needed dental work done before you start cancer treatment. Or schedule it for after treatment. Depending on how healthy your mouth and teeth are, you may need to see an oncologic dentist before cancer treatment. This is a dentist who specializes in treating people diagnosed with cancer. Learn more about dental and oral health.

Tips for managing more than one co-existing condition

Many people with cancer and cancer survivors, especially adults who are 65 and older, have more than one co-existing condition. This can make cancer care and follow-up care more complicated.

If you have multiple co-existing conditions, these tips can help you and your health care team manage your overall health care:

Keep your personal medical record up-to-date. When you first meet with your cancer care team, it is important to tell them about your complete medical history. This helps your doctor lower your risk of drug interactions, side effects, and other problems from cancer treatment. It is also important to keep your cancer care team updated on any changes to your overall health or other health conditions. Maintain and bring a personal medical record to your oncology appointments. This record should include information about:

  • Any chronic health problems

  • Your medications, including how much you take, how often, and any side effects they cause

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

  • Other surgeries or medical procedures you have had

  • Medical tests and results

  • Contact information for your other health care providers

Receive palliative care or supportive care. When a person has cancer and multiple other health problems, meeting with a palliative care provider may help as another layer of support. Palliative care or supportive care is treatment to relieve symptoms. It is often started soon after diagnosis and continues throughout treatment.

Palliative care helps people live better with serious and chronic illness. The palliative care team will focus on your quality of life and health goals, as well as communicating with your other health care providers. A palliative care provider can address the impacts of illness on other parts of your life, help with symptoms, and help you plan for the future.

Continue to see the doctors treating your other conditions. Keep your appointments with any doctors you saw before your cancer diagnosis. For example, if you see a primary care doctor and a cardiologist, you should continue to attend your regularly scheduled appointments with them while you see your cancer care team. At these appointments, make sure they are aware of your current cancer treatment plan and any new or worsening symptoms. In the United States, Medicare requires an annual wellness exam to keep your coverage. Even if you are receiving cancer treatment, you need to keep this wellness appointment with your primary care doctor.

Keep track of your medications. When you have co-existing conditions, it is very important that you keep track of your medications. You may be taking many different kinds of medications with different requirements.

Follow these suggestions for keeping track of the different medications you are taking:

  • Take your medications on time and as prescribed by your doctor, such as with or without food

  • Read all of the medication label on the container to make sure you take the right dose

  • Use a chart, pill calendar, or your phone's calendar reminder to set a schedule and track when you take your medication

  • Use a weekly pill case so you know whether you've taken each day's medication

  • Fill all prescriptions at the same pharmacy so your pharmacist has a complete list of your medications and current dosages

  • Keep this list with you when you go to each medical appointment

Learn other ways your pharmacist can support you during cancer. And, always let your other doctors know if you have been prescribed a new medication or if the dose changes.

You should also let your health care team know if you are taking any over-the-counter dietary supplements, like vitamins or herbs. These can also cause unwanted drug interactions.

Questions to ask the health care team

  • Will any of my co-existing conditions affect my cancer treatment, or vice versa?

  • How will my overall health be monitored during my cancer treatment?

  • Could any of the medications I am currently taking interact with the medications I will take during cancer treatment?

  • Will I need to stop any of my current medications during cancer treatment? If so, will I take another medication instead?

  • Who should I tell if I develop any new side effects or another health condition? How soon?

  • Who can I talk with if I'm feeling anxious or upset about my health?

  • Do you know of any resources that can help me manage my co-existing condition(s) at home?

Related Resources

Tips for Managing Multiple Medications

Cancer and Aging

Managing Your Care