Cancer and Chronic Conditions : Addressing the Problem of Multimorbidity in Cancer Patients and Survivors

This book addresses the growing problem of multimorbidity in cancer patients and survivors with the focus on how to best integrate the effective cancer care with the care of multiple chronic conditions. As cancer is more prevalent in older individuals, many patients with cancer also suffer from other chronic conditions that impact on the uptake, tolerance and outcomes of cancer treatment and their long term mortality and morbidity. In addition, cancer and its treatment increase the risk of future chronic conditions. Readers will examine the prevalence and predictors of chronic conditions in cancer, impact of chronic conditions on screening and treatment, evidence for preventative strategies that address both cancer and chronic conditions, emerging management and care integration strategies and directions for management of multimorbidity in special cancer populations – the very young, the very old and those at the end of life. Authored by clinicians and researchers from diverse expertise including epidemiology, sociology, hematology, medical oncology, palliative care, pharmacy and representing Australia, New Zealand, US, Canada and the Netherlands, the book brings an international perspective to a problem that affects all cancer settings. The book is going to be of interest to diverse professionals interested in cancer control including epidemiologists, public health researchers, policy makers as well as clinicians dealing with cancer patients within specialist cancer and non-cancer and primary care settings. This book addresses the growing problem of multimorbidity in cancer patients and survivors with the focus on how to best integrate the effective cancer care with the care of multiple chronic conditions. As cancer is more prevalent in older individuals, many patients with cancer also suffer from other chronic conditions that impact on the uptake, tolerance and outcomes of cancer treatment and their long term mortality and morbidity. In addition, cancer and its treatment increase the risk of future chronic conditions. Readers will examine the prevalence and predictors of chronic conditions in cancer, impact of chronic conditions on screening and treatment, evidence for preventative strategies that address both cancer and chronic conditions, emerging management and care integration strategies and directions for management of multimorbidity in special cancer populations ĺl the very young, the very old and those at the end of life. Authored by clinicians and researchers from diverse expertise including epidemiology, sociology, hematology, medical oncology, palliative care, pharmacy and representing Australia, New Zealand, US, Canada and the Netherlands, the book brings an international perspective to a problem that affects all cancer settings. The book is going to be of interest to diverse professionals interested in cancer control including epidemiologists, public health researchers, policy makers as well as clinicians dealing with cancer patients within specialist cancer and non-cancer and primary care settings Front Matter....Pages i-xii What Is Comorbidity?....Pages 1-33 How Do We Measure Comorbidity?....Pages 35-70 Cancer, Chronic Conditions and Social Disadvantage—The Perfect Storm....Pages 71-103 Impact of Comorbidity on Cancer Screening and Diagnosis....Pages 105-129 Impact of Comorbidity on Treatment Decision Making and Outcomes....Pages 131-158 The Impact of Cancer and Chronic Conditions on Caregivers and Family Members....Pages 159-202 Prevention of Chronic Conditions and Cancer....Pages 203-239 Chronic Condition Management Models for Cancer Care and Survivorship....Pages 241-259 The Management of Polypharmacy in People with Cancer and Chronic Conditions....Pages 261-286 Breaking the Silos: Integrated Care for Cancer and Chronic Conditions....Pages 287-313 Advocacy in Cancer and Chronic Conditions—Challenges and Opportunities....Pages 315-339 Research Considerations in Patients with Cancer and Comorbidity....Pages 341-369 The Cost of Cure: Chronic Conditions in Survivors of Child, Adolescent, and Young Adult Cancers....Pages 371-420 Chronic Conditions and Cancer in Older Adults....Pages 421-454 Chronic Conditions and Cancer at the End of Life....Pages 455-475 2.12 Weighted Indices -- 2.13 Content and Face Validity -- 2.14 Criterion Validity -- 2.14.1 Concurrent -- 2.14.2 Predictive -- 2.15 Reliability -- 2.16 Feasibility -- 2.17 Other Approaches to Measuring Comorbidity in Cancer Populations -- 2.18 Content and Face Validity -- 2.19 Criterion Validity -- 2.19.1 Concurrent -- 2.19.2 Predictive -- 2.20 Reliability -- 2.21 Feasibility -- 2.22 So Which Index Is Best? -- 2.23 Future Directions for Practice or Research -- References -- Further reading -- 3 Cancer, Chronic Conditions and Social Disadvantage-The Perfect Storm -- Abstract -- 3.1 Introduction Foreword -- Preface -- Contents -- 1 What Is Comorbidity? -- Abstract -- 1.1 What Is Comorbidity? -- 1.2 The Evolution of the Concept of Comorbidity -- 1.3 Diagnostic-Based Risk (or Case-Mix) Adjustment Systems -- 1.4 Clinically-Based Comorbidity Indices -- 1.5 Recent Evolution Relating to the Concept of Comorbidity -- 1.6 Constructs Related to Comorbidity -- 1.7 Multimorbidity -- 1.8 Functional (or Performance) Status -- 1.9 Disability -- 1.10 Allostatic Load -- 1.11 Frailty -- 1.12 Burden of Disease/Illness -- 1.13 Complexity -- 1.14 How Are the Comorbidity-Related Constructs Linked? 1.18.6 There May Be Common Genetic or Physiological Pathways Between Cancer and Comorbidities -- 1.19 Future Directions for Practice or Research -- References -- 2 How Do We Measure Comorbidity? -- Abstract -- 2.1 Introduction -- 2.2 Individual Conditions or Counts of Conditions -- 2.3 Content and Face Validity -- 2.4 Criterion Validity -- 2.4.1 Concurrent -- 2.4.2 Predictive -- 2.5 Reliability -- 2.6 Feasibility -- 2.7 Organ-Based Approaches -- 2.8 Content and Face Validity -- 2.9 Criterion Validity -- 2.9.1 Concurrent -- 2.9.2 Predictive -- 2.10 Reliability -- 2.11 Feasibility 3.2 The Theory of Social Quality as a Conceptual Framework for Understanding Socio-economic Status -- 3.3 The Role of Healthcare Services in Addressing Social Quality for Vulnerable Groups -- 3.4 The Need for More Equitable Access to Healthcare Services for Vulnerable Groups -- 3.5 Inequity, Inequality and Disparity: What Is the Difference and How Do We Measure 'Equity'? -- 3.6 Culturally Diverse Patients in the Context of Cancer Care and Chronic Disease -- 3.6.1 Cultural Diversity and Its Challenges Within the USA, UK, Canada and Australia -- 3.7 Ethnicity and Cancer Care 1.15 Why Should We Focus on Comorbidity in Cancer? -- 1.16 How Common Is Comorbidity in Cancer? -- 1.17 Cancer, Comorbidity and Disparity -- 1.18 Why Do Cancer and Comorbidity Coexist? -- 1.18.1 Common Conditions Occur Commonly -- 1.18.2 Cancer and Comorbid Conditions Share Many Common Risk Factors -- 1.18.3 Comorbidity May Increase or Decrease Predisposition to Cancer -- 1.18.4 Treatment for Comorbidity May Increase or Decrease the Risk of Cancer -- 1.18.5 Treatment for Cancer May Cause or Exacerbate Comorbidity 3.7.1 Communication with Culturally Diverse Patients in Cancer Care Settings