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What are Comorbid Conditions?

Comorbidity occurs when someone has two or more diseases or conditions at the same time. Comorbid conditions are often chronic or long-term health problems, such as diabetes and high blood pressure. 

Comorbidities in cancer care are quite common. For example, 38% of pleural mesothelioma patients and 52.9% of lung cancer patients have comorbid conditions. These additional conditions may contribute to an earlier cancer diagnosis because of more frequent doctor’s visits.

Research on the impact of comorbidities on mesothelioma survival rates shows mixed results. Researchers theorize the potential for improved survival may be related to an earlier mesothelioma diagnosis, better care throughout treatment and potential anti-cancer effects of medications for comorbid conditions. However, there’s also evidence that coexisting health problems negatively affect mesothelioma survival.

Types of Mesothelioma Comorbidities

The most common comorbid conditions associated with mesothelioma include coronary artery disease, high blood pressure and diabetes. Other comorbidities are primarily related to asbestos exposure. 

Coronary Artery Disease 

Smoking, high cholesterol, poor diet, genetics and a lack of regular exercise can lead to a heart condition called coronary artery disease. With CAD, plaque builds up inside the artery walls and restricts blood flow to the heart.

High Blood Pressure

High blood pressure, also known as hypertension, occurs when the force of blood coursing through the blood vessels is too high. Age, lack of exercise, diabetes, high-sodium diets, stress and obesity are common risk factors for high blood pressure.

Diabetes

Diabetes is a chronic condition that affects how your body turns food into energy. People with diabetes have too much sugar in their blood, putting them at higher risk for additional problems, such as loss of vision, kidney disease and poor wound healing. A  combination of genetic and environmental factors can increase the risk of diabetes.

Asbestosis

Asbestosis is a chronic, progressive lung disease caused by asbestos exposure. People with this condition were exposed to enough asbestos to be considered at risk for mesothelioma and lung cancer. The chance of developing lung cancer after an asbestosis diagnosis is higher than the likelihood of mesothelioma, but researchers aren’t sure why.

Pleural or Peritoneal Effusion

Pleural and peritoneal effusions are buildups of fluid in the chest linings and abdominal cavities. Excess fluid in these mesothelial linings is associated with asbestos exposure and may occur without a mesothelioma diagnosis or before. Effusions are a common symptom of mesothelioma.

Pleural Diseases

Certain pleural diseases, including pleural plaques, pleuritis and diffuse pleural thickening, are associated with asbestos exposure and the development of mesothelioma. While not everyone who develops these asbestos-related conditions is diagnosed with mesothelioma, they may mean the person was exposed to enough asbestos to be at risk of asbestos-related cancer.

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease, or COPD, is a lung disease that commonly refers to chronic bronchitis and emphysema. Smoking is the primary cause of COPD, but it may also develop in people who work in dusty, toxic workplaces such as asbestos job sites.  

Other potential comorbid conditions include skin cancer, ovarian tumors, disc hernia, epilepsy, benign prostate disease (enlarged prostate), liver disease, vascular disease, peptic ulcer and rheumatic disease.

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How Are Coexisting Conditions Treated with Mesothelioma?

Doctors typically treat comorbid conditions the same whether the person has mesothelioma or not. However, coordination of care is crucial for mesothelioma patients with comorbidities to ensure proper treatment for chronic conditions throughout mesothelioma treatment

Patients with mesothelioma and comorbidities are at an increased risk of severe complications after surgery and during chemotherapy. As a result, patient selection for these treatments should be carefully considered.

Certain conditions, such as heart disease, may limit patient eligibility for aggressive treatments, including surgery. Individuals with comorbid conditions may still be considered for certain surgical procedures, including pleurectomy and decortication, because this procedure is less aggressive than an extrapleural pneumonectomy. 

Additionally, some medications for comorbid conditions should not be taken during cancer treatment. For example, antacids must be discontinued while undergoing targeted therapy because they limit drug absorption. Furthermore, some supplements, such as St. John’s wort, may interfere with chemotherapy drugs.

Tips for Patients with Coexisting Conditions

Caring for your overall health while receiving cancer treatment is essential for people with comorbid conditions. It’s also important to reach out to your health insurance provider to learn how your plan covers cancer care and chronic health conditions. 

Here are some tips to help balance comorbidities and mesothelioma treatment:

  • Address New Symptoms: Call your doctor about any symptoms that develop as soon as possible. Delaying treatment of new symptoms could result in unwanted complications.
  • Keep Your Appointments: While you may be focused on anti-cancer treatment, it is important to keep your appointments for other health conditions to avoid potential complications.
  • Manage Side Effects: Certain side effects of cancer treatment may make it difficult to manage chronic conditions. For example, nausea and vomiting make it difficult to manage blood sugar when you have diabetes.
  • Take All Medications: Don’t stop taking medicines prescribed by your regular doctor during cancer treatment. Make sure to discuss all your medications with your mesothelioma doctor to avoid potential interactions.
  • Take Care of Your Mental Health: Coping with cancer on top of chronic conditions is stressful and may feel overwhelming at times. Reach out to family, friends or a mental health professional to get the support you need.

If you have a history of asbestos exposure and haven’t been diagnosed with mesothelioma, it is important to see your doctor if you develop any new symptoms. Research shows mesothelioma patients with a comorbidity have a longer duration of symptoms, which means proper treatment was delayed. People with chronic conditions should not ignore new symptoms because they may indicate a serious condition is developing.

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