The treatment of co-morbidities in older patients with metastatic cancer

The purpose of the study was to determine whether older patients with metastatic cancer continue to take medications for the treatment of pre-existing co-morbidities after the diagnosis of metastatic disease.

Between November 2008 and June 2009, patients over the age of 65 with metastatic cancer were interviewed. Medical records were reviewed in order to ascertain current medication use and relevant past medical history. Classes of medication of interest were prospectively defined; these were anti-hypertensives, lipid-lowering drugs, anti-platelet agents, anti-coagulants and bisphosphonates.

One hundred patients were recruited, with a median age of 73.5 years (range 65-88); 52% were women. The primary cancer sites were breast, 36%; prostate, 27%; colon, 14%; other, 23%. The median performance status of the patients was 2. The median number of medications was 7 (range 1-17). Eighty-one percent of patients were found to be taking one or more of the predefined medications for treatment of a long-term co-morbidity. Overall 52% of patients had side effects attributed to these medications.

Patients with metastatic cancer continue to take drugs for prevention of co-morbidities which are associated with side effects and inconvenience. The benefits of these drugs are likely to be minimal, and medication reviews should be undertaken to address their appropriateness.