Chronic diseases hinder good cancer survival rates

November 15, 2013

There are many people in this position and the number is increasing; cancer patients who not only have to fight against cancer, but also suffer from other diseases. So-called comorbidity is a large and growing problem, not least because we are becoming older and age increases the risk of contracting cancer as well as other diseases.

How much diseases such as diabetes, COPD (chronic obstructive pulmonary ), arthritis, depression and cardiovascular disease mean for depends on the type of cancer; but the overall picture is the same. Other diseases have a strong negative impact on both the one and five-year survival rate. For example, for breast cancer the five-year survival rate for patients without other diseases is 83 percent. For patients with one or two other chronic diseases the survival rate is 64 percent, while it is 50 percent for those with three or more diseases. This is shown by new figures from the Central Denmark Region that have just been published in a special edition of the scientific journal Clinical Epidemiology. This edition focuses on cancer and comorbidity and is based on research from Aarhus University and Aarhus University Hospital.

Poorer survival to be expected - but not so poor

According to Henrik Toft Sørensen, professor of at Aarhus University and Aarhus University Hospital, it is to be expected that are worse if you have a poorer state of health. But it is problematic that a similar improvement in the survival rate of this group of has not happened.

"Our studies show that other diseases have a very significant importance for survival, and we can see that these patients have not experienced the same progress in survival rates as other cancer patients have experienced during the last 15 years," says professor Henrik Toft Sørensen, who has written the editorial in the journal.

The problem has previously been overlooked, though there has been greater awareness following the publication of specific figures on the problem 10 years ago.

"It has long been the case that cancer doctors are concerned with cancer, arthritis doctors with arthritis and so on. But increasing attention is being paid to the significance of the patients having other diseases," he says.

Many patients have other diseases

It is estimated that around 40 percent of all Danish cancer patients have one or more other diseases with which they have been hospitalised. 30 percent have one or two other diseases, while 10 percent have three or more diseases. This appears from a systematic literature review (SLR) of all of the studies of comorbidity and breast, lung and colon cancer that have been carried out in Denmark and abroad over the past decade. The study is financed by the Danish Cancer Society and has just been published in the journal Clinical Epidemiology, along with the new figures.

That so many also have other diseases is due not only to age but also unhealthy lifestyles. According to Henrik Toft Sørensen, part of the explanation of the poor survival rate can also be found here. Smoking, alcohol and being overweight simply give a poorer rate of survival. After these factors, what means something here is the treatment. Among other things because patients with other diseases have a greatly increased risk of complications, but also because there is a risk of them receiving either too much or too little treatment.

Lack of knowledge about the proper treatment

Whether it is the cancer that the patients die of is unclear, explains PhD Mette Søgaard, Clinical Epidemiological Department, Aarhus University and Aarhus University Hospital, who are behind the literature review.

"It is not clear what the patients die of - whether it is the cancer or the other diseases. However, we can see that it is neither due to the fact that they have a more aggressive cancer, that the disease is more advanced when detected, or that the patients are older," she says.

What can be seen, however, is that cancer patients with other diseases do not receive the same treatment as other cancer patients. This is probably because they cannot tolerate the treatment quite as well and because they experience complications more often than other patients. According to Mette Søgaard, it could nonetheless be interesting to investigate whether we use the right treatment.

"There are still a lot of unanswered questions - not least whether some of these patients are receiving too little treatment," she says.

Frede Olesen, chairman of the Danish Cancer Society shares this assessment:

"It is obvious that the treatment must often be individually adapted when there are several concurrent diseases. But basically, the poor results are unsatisfactory and we must focus our research on the reasons for this lack of progress. We have to carefully examine whether the quality of the simultaneous treatment of several diseases is good enough," says Frede Olesen.

Explore further: Nuclear medicine therapy increases survival for patients with colorectal cancer liver metastases

More information: Clinical Epidemiology 2013, 5:1-2 www.dovepress.com/clinical-epidemiology-i833-j43

Related Stories

Nuclear medicine therapy increases survival for patients with colorectal cancer liver metastases

November 6, 2013
For patients who fail to respond to current first-line and second-line treatments for colorectal cancer liver metastases (also known as salvage patients), radioembolization with Y-90 microspheres could extend survival according ...

Genetic aberration paves the way for new treatment of cancer disease

November 6, 2013
(University of Copenhagen) Researchers from Faculty of Health and Medical Sciences, University of Copenhagen, have characterized a genetic aberration on a group of colorectal cancer patients. The discovery gives hope for ...

Chemotherapy drug improves survival following surgery for pancreatic cancer

October 8, 2013
Among patients with pancreatic cancer who had surgery for removal of the cancer, treatment with the drug gemcitabine for 6 months resulted in increased overall survival as well as disease-free survival, compared with observation ...

Lung cancer patients with diabetes show prolonged survival

October 17, 2011
Lung cancer patients with diabetes tend to live longer than patients without diabetes, according to a Norwegian study published in the November issue of the Journal of Thoracic Oncology, the official publication of the International ...

Worse outcomes for older breast cancer patients with other health problems

June 30, 2011
Older breast cancer patients with certain other health problems have higher mortality rates than patients without these problems according to a study published online June 30 in the Journal of the National Cancer Institute. ...

Minimally invasive operation helps elderly patients after colon cancer treatment

October 8, 2013
The chance of ending up in a nursing facility appears to be significantly lower for older patients who undergo a laparoscopic procedure than for those who have open surgical resection for colon cancer, according to a study ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.