Key result
The editorial argues that the continuation of preventative non-cancer medications in patients with incurable cancer should be carefully reconsidered due to limited life expectancy and potential harms.
Highlights the overlooked issue of managing preventative non-cancer medications in patients with incurable cancer, calling for careful consideration of their uncertain benefits and risks.
Patients starting palliative systemic therapy for incurable cancer will often be taking medications on repeat prescription for pre-existing medical disorders. Common examples include antihypertensives, statins, and anticoagulants for the primary or secondary prevention of cardiovascular disorders. Such drugs have uncertain benefits in patients whose life-expectancy is now dominated by advanced cancer, rather than future non-cancer risks. Most landmark studies establishing common preventative medications did not include significant numbers of cancer patients, or excluded them altogether. There is also uncertainty around the risks and side effects of non-cancer medications in patients with cancer. Indeed it appears that, at least within the medical literature, this issue has been almost entirely overlooked by the oncology and wider healthcare communities. Attention is needed as practitioners remain uncertain about how to manage their patient's comorbidities alongside a new diagnosis of cancer. The important role of the GP as an expert in primary and secondary prevention may not be appreciated by patients, oncologists, and the GPs themselves, where the assumption exists that an oncologist will manage, with competence, all aspects of a cancer patient's care. We shall consider some examples. In the case of statins for the primary prevention of coronary heart disease, the WOSCOPS study was a pivotal randomised controlled trial that justified the use of pravastatin in this setting. With an average follow-up of 5 years, the …
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Hall et al. (2010) conducted an editorial in Incurable cancer with comorbidities. Preventative non-cancer medications (e.g., statins, antihypertensives) was evaluated. The editorial argues that the continuation of preventative non-cancer medications in patients with incurable cancer should be carefully reconsidered due to limited life expectancy and potential harms.
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