Treating More Than the Breast Cancer

Co-morbidities affect survival of older breast cancer patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Older women diagnosed with breast cancer often have other health problems which can affect their overall survival. So it's important for primary care physicians to work with oncologists to treat the whole woman.

Having other health problems, along with breast cancer, can increase the risk of death in older women. Those are findings of a recent National Cancer Institute (NCI) study.

"Breast cancer patients should speak with both GPs and Oncologists."

Co-morbidities - or other health problems - often seen in older women diagnosed with breast cancer include 13 different conditions: heart attack, congestive heart failure, stroke, chronic obstructive pulmonary disease (COPD), diabetes, chronic kidney disease, dementia, liver disease, arthritis, previous cancers, paralysis, peripheral vascular disease and ulcers.

Lead investigator Jennifer L. Patnaik, Ph.D., of the University of Colorado Denver, Aurora and colleagues analyzed links between each of these conditions and survival among older breast cancer patients.

The study involved 64,034 women age 66 years and older who were diagnosed with breast cancer between 1992 and 2000. Researchers used the Surveillance, Epidemiology, and End Results (SEER) Medicare database to identify the participants.

Among all the participants, 42 percent had a history of one or more of the 13 conditions. Of this group, women ages 66-74 who had stage I cancers had the same survival rates as women with stage II tumors who did not have any other health problems.

Previous research has shown that co-morbidities are associated with poorer outcomes and higher deaths in women with breast cancer.

This study goes one step further. The authors conclude that comorbidities are important in predicting survival of breast cancer patients.

Worta McCaskill-Stevens, M.D., of the National Cancer Institute, who wrote an accompanying editiorial commenting on the study, said this research illustrates the need for primary care physicians to team with oncologists in managing the care of older breast cancer patients.

"Primary care physicians are not always comfortable in managing cancer or cancer-related symptoms, but they manage many of the coexisting diseases that are present in cancer patients," said Dr. McCaskill-Stevens.

"Many of these co-morbidities increase with age and the fact that cancer outcomes are influenced by these co-morbidities in the elderly, provides an excellent opportunity and a rationale for the co-management of these patients," she said.

Dr. McCaskill-Stevens concludes that systems for continuous communication and sharing of patient records and care plans need to be optimized to achieve this co-managment.

This study was published in the Journal of the National Cancer Institute.

Reviewed by: 
Review Date: 
July 6, 2011
Last Updated:
October 18, 2012