Dr Joseph Alvarnas on How Comorbidities Impact Care Decisions for Cancer Patients
A cancer patient’s comorbid diseases have important implications for setting goals and selecting treatment, said Joseph Alvarnas, MD, of the City of Hope and editor-in-chief of Evidence-Based Oncology. Clinicians must keep comorbidities in mind as they base oncology care upon that person as an individual.
Transcript (slightly modified) How do comorbidities impact outcomes in cancer patients?
One of the things that’s clear is that the selection of care, ranging from the goals of care and the scope of care and the therapeutics that might be chosen, have to be based upon that person as an individual. As the population ages, and as people with cancer age, the issue of multiple comorbidities – diabetes, hypertension, coronary artery disease, renal failure, things which we know are part of that patient’s experience independent of cancer – does have very important implications in treatment decisions, in the selection of different types of therapeutics based upon those comorbidities. As well as the strategy of care, how best to manage that individual and how best to create goals which are really realistic in light of their full complexity.
So I think when we think about value-based care, and goals of care, and the focus of care, we’re really talking about individualizing treatments in ways that extend beyond genetics and genomics and proteomics, to really understanding the full breadth of that person’s health prior to the advent of cancer, and seeing how that really has an inextricable influence upon the care decisions that follow thereafter.