Chronic conditions like heart disease and diabetes are common in many people diagnosed with breast cancer. These chronic conditions can affect treatment options, increase treatment toxicity and lead to a poorer prognosis. Until now, little was known about how these additional chronic conditions affected the long-term survival of cancer patients, including survival of patients with breast cancer.
A new large Australian study, published in the Medical Journal of Australia, has examined the long–term survival of 32,646 cancer patients from the South Australian Cancer Registry. The study was led by two NBCF-funded researchers, Professors Bogda Koczwara (Flinders University) and Professor David Roder (University of South Australia).
The patients were diagnosed with cancer between 1990-1999, alive for at least five years after diagnosis, and followed up on average for 17 years. Of 32, 646 people with cancer alive five years after diagnosis, 17, 268 deaths were recorded (53% of patients): 7, 845 were attributed to cancer (45% of deaths) and 9, 423 were attributed to non-cancer causes (55%). Ischaemic heart disease was the leading cause of death (2, 393 deaths) for the cohort, and the cumulative number of cardiovascular deaths exceeded that of cancer cause-specific deaths from 13 years after cancer diagnosis.
The study included 6, 259 patients diagnosed with breast cancer, which was also the most common cancer type amongst the cohort. Of the 6, 259 patients with breast cancer, the researchers found that the majority (3, 516 survivors, 56.2%) were still alive when followed up in December 2016. While 23% (1, 439) had died from cancer, 20.8% (1, 304) had died from non-cancer illnesses. Patients with breast cancer were 25% more likely to die from cardiovascular disease compared to the general population.
Lead author, Professor Koczwara, explained that the findings of this study will lead to improved care pathways for cancer survivors in Australia.
“Currently, the management of chronic conditions, such as cardiovascular disease, is not always well integrated into the routine care of cancer patients,” she said.
Professor Koczwara is currently working on a NBCF-funded project to develop a new nurse-led clinical pathway to minimise the impact of cardiovascular disease in people with breast cancer, which will help to improve their long-term health outcomes.