Comorbidities: Prequel or Sequel to Cancer?

Maurie Markman, MD


September 09, 2013

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Hello. I'm Dr. Maurie Markman from Cancer Treatment Centers of America. I wanted to briefly discuss a very interesting paper that appeared in Gynecologic Oncology. The paper was titled "Prevalence and Incidence of Comorbidities in Elderly Women With Ovarian Cancer." The authors looked at the incidence of comorbidities in 5000 women with ovarian cancer and a corresponding number of women at comparable ages who did not have cancer. As might be anticipated, the investigators did not find a major difference in comorbidities between the 2 patient populations.

However, when the investigators looked at 3 months and 12 months after the women were diagnosed with ovarian cancer, they found quite a bit higher incidence of comorbidities in the women with ovarian cancer compared with the cancer-free population. These data are quite provocative and suggest several possibilities. First, it is possible that the comorbidities identified in the patients with ovarian cancer represent toxicities of the treatment programs. Another possibility, however, is that as these women were being evaluated for ovarian cancer and undergoing workup, these comorbidities were discovered and hopefully appropriately treated, which would have a positive effect not only on the ability to continue treatment but also on the underlying problems related to comorbidities, such as diabetes, severe hypertension, and cardiac disease.

This is a very provocative report. It will be very interesting to see if other databases come up with similar conclusions. I think one conclusion has to be that the incidence of comorbidities seen in clinical trials at the time of initial diagnosis may not be a completely accurate reflection of the incidence of comorbidities that occur later in the course of the illness, either related to the treatment itself or perhaps because of the workup that is undertaken when a patient is diagnosed with cancer.

Again, this very interesting paper appeared in Gynecologic Oncology. I encourage you to read it if you are interested in this topic. Thank you for your attention.


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