Bridging Internal Medicine and Oncology: A Holistic Approach to Managing Cancer Comorbidities

Abstract

Background: Cancer patients also have frequent comorbidities that complicate treatment and influence outcomes. In Pakistan, there is limited integration between internal medicine and oncology, which worsens the challenges. This study assesses the prevalence, influence, and management of cancer comorbidities, with the suggestion of a holistic care approach.

Methods: A cross-sectional, observational study was performed in several healthcare centers in Pakistan among 500 cancer patients aged 18 years and above. Demographic data, type of cancer and stage, comorbidities, outcomes of the treatment, and patient self-reported outcomes were gathered. Multidisciplinary care practices and health system factors were measured. Statistical analysis, i.e., logistic regression, was applied to determine the predictors of unfavorable outcomes.

Results: Comorbidities were present in 68% of patients, of whom hypertension (35%) and diabetes (30%) were the most frequent. Comorbidity patients experienced longer delays in starting treatment (median 45 days vs. 25 days, p<0.01) and more treatment complications. Multidisciplinary treatment was related to better outcomes, such as increased treatment adherence and fewer hospitalizations. Nonetheless, health inequalities, especially between public and private facilities, restricted equal access to integrated care. These predictors of poor outcomes were stage of advanced cancer and multiple comorbidities.

Conclusions: Internal medicine and oncology must be bridged to address cancer comorbidities in Pakistan. System reforms and collaborative, multidisciplinary models of care are required in order to enhance outcomes and equity in cancer care. More research is needed on long-term effects and cost-effectiveness.