When Cancer is Not Your Only Health Concern

Approved by the Cancer.Net Editorial Board, 05/2019

People age 65 and older are more likely to have one or more long-lasting health problems in addition to cancer. These may include:

  • High blood pressure

  • Heart disease

  • Lung disease

  • Diabetes

  • Kidney disease

  • Arthritis

When you have cancer, these other health problems are called co-existing conditions. Another name is chronic conditions.

It can be easy to ignore your other health conditions when you have cancer. For example, taking care of your high blood pressure or diabetes can seem much less important than getting cancer treatment. But the success of your cancer treatment is partly based on your general health. This includes how you take care of other health conditions.

You can have a health problem like diabetes or depression at any age. But if you are an older adult, you may have a higher risk of side effects and longer recovery times because of these chronic problems. So, taking care of your other health conditions is especially important as an older adult.

Cancer treatment risks if you have other health problems

It is important to know how a chronic health problem can affect cancer treatment. Risks can include:

  • Reactions between your cancer drugs and other medications

  • 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 other health problems

It is important to tell your health care team about other health problems and any medications you take for them. Your health care team will work with you to lower these risks. For example, your doctor might ask you to stop taking or switch some medicines during cancer treatment. This is because some drugs can react with cancer treatments or medicine you take for the side effects of treatment.

Managing your other health problems during cancer treatment

Many health problems are more likely for older adults than younger people. 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 and/or blood pressure. This is often more of a concern for older adults, who may already have a higher risk of these conditions. Or they may already have heart problems or high blood pressure.

Ask your health care team if your cancer treatment or medications might affect your heart and/or blood pressure. It is important to work with your oncologist and cardiologist to adjust your medications and protect your heart during cancer treatment. If needed, your doctor may also test your heart function and blood pressure regularly during treatment.

Lung disease. Some types of chemotherapy may increase 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).

Smoking. Smoking raises your risk of lung problems. Recovery from surgery may take longer due to smoking. Cancer treatments such as radiation therapy may also be harder to cope with. Quitting smoking can help improve a person’s health. Learn about stopping tobacco use after a cancer diagnosis.

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. They might also go up because you are less physically active or under stress. Side effects like nausea and vomiting or changes in your diet will also affect your blood sugar.

Work with your health care team to make a good 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.

Kidney disease. Your kidneys might not work as well as you get older. If you are taking a cancer drug that might affect your kidneys, you will probably have regular blood tests done to check how they are working. Certain drugs, including some types of chemotherapy, may be harder for your kidneys if you are older than 65. This can raise your risk of kidney problems. How well your kidneys work might determine the type of chemotherapy you can have, or how often you have it.

Pain and problems moving around. You can have these problems at any age. But they are more common in older adults than younger people. For example, arthritis is a common cause of pain and movement problems. These problems can make it harder to do your daily activities or get to 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.

Depression and anxiety. You may experience depression and anxiety when you first learn that you have cancer. But it can also happen while you are receiving treatment. Depression and anxiety can make it difficult to:

  • Make decisions about treatment

  • Take medication on time or have important tests

  • Ask for support from your family and other loved ones

Depression and anxiety can happen in people of aany age. But they are not part of getting older or having cancer. Depression and anxiety are health conditions that can be treated.

Medication for depression and anxiety may be helpful. But during cancer treatment, your doctor might ask you to change your medication. You might even need to stop taking it during treatment if it could react with your cancer treatment.

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

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

Stomach and nutrition problems. You might not feel like eating when you are receiving cancer treatment. Or your body might have problems getting enough nutrition from your food. So you might lose weight when you do not need to or without trying. Chemotherapy can make these problems worse, especially if it causes nausea, vomiting, or diarrhea.

Some older adults might not be able to eat easily. This can be because of missing teeth, new dentures, or certain medications. Tell your health care team if you have trouble eating.

Your doctor or a registered dietitian can help make sure you are getting the nutrition you need during treatment.

Blood counts. During cancer treatment, you may be at risk for changes in your blood counts. This can include low levels of red blood cells, which can lead to anemia. It can also include low levels of white blood cells or platelets. Your health care team may watch your blood counts carefully while you are on treatment. If blood counts become low, you may receive medication or a blood transfusion.

Memory loss and mental confusion. Older adults are more likely to have these problems even without cancer. Problems can include memory loss or difficulty remembering things, confusion, or changes in thinking. Tell your health care team if you are experiencing these symptoms.

Alcohol overuse. Alcohol and other drugs can change your ability to make treatment decisions. It can also make it harder to do daily activities such as taking medication and having important screenings or tests. Using alcohol or other drugs can sometimes interfere with cancer treatments. Talk with your health care team about alcohol and other drugs during cancer treatment.

Talking with the health care team

When you talk about cancer treatment with your health care team, bring your personal medical record. This helps your doctor lower your risk of reactions and other problems from treatment. Your medical 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 doctors

Related Resources

Cancer.Net Podcast: Improving Quality of Cancer Care for Older Adults

Cancer Care Decisions for Older Adults

Tips for Managing Multiple Medications