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.

Co-existing conditions are health problems that a person has along with cancer, such as high blood pressure, diabetes, or depression. These conditions often influence how treatment affects a person with cancer, including:

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

Knowing how your chronic conditions could affect treatment and recovery is an important part choosing treatment options.

Common co-existing conditions affected by treatment and recovery

Co-existing medical 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, including other conditions you may have that are not on this list:

Heart conditions. Congestive heart failure, high blood pressure, arrhythmia (irregular heart beat), and a decrease in heart function may lessen your 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 (a lung disease that causes difficulty breathing), chronic obstructive pulmonary disease (loss of lung function), and decreased lung function affect how well your 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 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 also cause a decreased appetite or weight loss. Talk with your doctor or a registered dietitian (RD) for information on how to make sure you’re eating enough during cancer treatment.

Smoking. Smoking increases the risk of developing lung problems after surgery and may increase recovery time. 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 can increase recovery time.

Anemia. Anemia (a decrease in red blood cells) can get worse during chemotherapy. Although anemia may not change the cancer treatment you receive, it can delay treatment if you need a longer time to recover between treatments. 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 or friends moving away can make some older adults feel alone, adding to feelings of depression. Depression, anxiety, and other mental health issues may also interfere with the ability to participate in treatment decision-making. Depression and anxiety are treatable, and it’s important to talk with your doctor because antidepressants or anti-anxiety medications could interact with chemotherapy.

Pain and immobility. Older adults can 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 your ability to get to doctor’s appointments or receive certain treatments. In addition, pain and immobility may increase the risk of side effects.

Memory loss and mental confusion. Older adults with cancer may experience memory loss, confusion, being in a mental fog, and/or a change in their thought process. This may be due to aging, or specific cancer drugs that cause what some call “chemo brain.” If possible, it may help to have a caregiver keep track of medications and appointments and a diary of the day’s events.

Learn more about dealing with chronic conditions when you have cancer.

Talking with your doctor

Before making decisions about cancer treatment, talk with your doctor about your health, including:

• The 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
  
  
• Any issues that may affect your ability to receive treatment, such as living alone, not having a way to get to appointments, and any
  
  
• The names and phone numbers of any other doctors who are taking care of you

You may also have questions about your health and treatment options before you can make an informed decision. Consider asking your doctor the following questions:

• What is my prognosis?
  
  
• What are all of my treatment options?
  
  
• What is the goal of each treatment?
  
  
• How does this treatment help me?
  
  
• What are some risks and potential side effects of this treatment?
  
  
• Will I need to be in the hospital for treatment, or will I be treated as an outpatient?
  
  
• How long will each treatment last?
  
  
• If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?
  
  
• How can I keep myself as healthy as possible during treatment?
  
  
• What support services are available to me? To my family?

For more ideas, see Questions to Ask Your Doctor.

More Information

Health Assessment

Cancer in Older Adults