What constitutes your medical history?

Any time you see a new doctor, one of the first things they’ll ask about is your medical history. That’s because everything from the aftermath of childhood diseases to the side effects of current medications can influence which treatments you’re offered for new conditions and how effective they might be.

But what actually makes up your “medical history,” and what are the most critical things to share with your doctor? Are there any areas of particular importance that cancer patients should mention?

We went to Amy Hassan, M.D., chair of General Oncology, for answers. Here are six things she wants every cancer patient to share with their doctors.

1. Chronic health conditions

Some cancer patients may think that if their diabetes or high blood pressure is well-controlled – whether through medication or lifestyle choices – then they don’t even need to bring it up. But that is not the case. Five underlying conditions you should always mention, regardless of their status, are:

• Hypertension (high blood pressure)
• Diabetes
• Heart disease
• Kidney or liver disorders
• Autoimmune disorders

“‘Controlled’ does not mean ‘gone,’” notes Hassan. “And chronic health conditions can influence your risk of complications from certain cancer treatments, or even determine whether or not they’re appropriate for you.”

Certain chemotherapy drugs might not be recommended, for instance, if you have an underlying heart condition. And a history of gestational diabetes could be relevant, even if you are not currently pregnant.

“The administration of steroids, which are used often during cancer treatment, can push someone who is already predisposed to developing diabetes over the edge into active disease, or exacerbate a case that was previously under control,” explains Hassan.

Autoimmune disorders such as lupus and rheumatoid arthritis can also flare up intermittently, even if they are not currently active.

2. Medications and nutritional supplements

When you share a list of current medications with your doctor, don’t limit yourself to the drugs you’ve been prescribed.

Anything you ingest – including vitamins, minerals, herbs and other dietary supplements – can affect your entire body once they enter your blood stream. Even substances that are absorbed through the skin, such as CBD oil or medicated creams or lotions, may interact with cancer drugs or other therapies, potentially rendering them less effective, ineffective or even harmful.

“A lot of times, people don’t think of non-prescription supplements as being relevant,” says Hassan. “They’re thought of as a safer alternative to more conventional treatments for pain, anxiety and other issues. But it’s important to remember that all of these supplements do have side effects. And, they could potentially interact with other medications and impact your cancer treatment.”

3. Childhood illnesses

It won’t be necessary to rattle off every time you developed strep throat. But if you ever had something out of the ordinary as a child – particularly a significant infection such as pneumonia or tuberculosis – it’s important to mention it.

“Even if it’s no longer active now, it could still be potentially relevant,” notes Hassan. “Having a history of serious infections as a child could be a sign of an impaired immune system. In addition, some infections, such as the human papillomavirus, also known as HPV, have been linked to different types of cancer.”

It’s also important to let medical providers know if you didn’t receive the standard, recommended schedule of childhood vaccinations for any reason.

“Cancer treatments can increase the risk of infection in general,” notes Hassan. “But if your immune system is compromised, you may be more susceptible to those diseases, even as an adult.”

4. Current infections

Hepatitis B and hepatitis C are chronic liver infections that can remain dormant in the body until “reactivated” by cancer treatment.

“Be sure to mention these or any other chronic infections you might have, such as AIDS or HIV, to your care team, as they could cause complications during your cancer treatment,” says Hassan.

5. Surgical procedures

Also tell your doctor about any major surgical procedures you’ve had, especially if you experienced serious complications, such as a reaction to anesthesia or excessive bleeding. 

Even if you’ve never had surgery, be sure to report any other unusual bleeding you may have experienced. 

“A history of heavy menstrual bleeding – or even prolonged bleeding after a dental procedure or giving birth – could be a sign of a bleeding disorder,” notes Hassan. “It’s important to let your care team know about these, so they can make appropriate preparations for any necessary procedures.”

6. Family illnesses

Some diseases run in families. So, if more than one direct ancestor has a particular condition, be sure to share that with your care team.

“Often, someone with colorectal cancer will mention relatives who’ve had that same type of cancer, but not close family members who’ve had other types of cancer,” says Hassan. “Certain hereditary cancer syndromes can increase the risk of multiple types of cancers, so it is important to report any cancers in your family.”

Addiction has also been known to run in families, so if anyone in yours struggles with substance abuse, be sure to mention that, too. Special precautions can be taken by your care team when prescribing painkillers, and alternatives can be suggested to prevent opioid addiction.

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