The receipt of chemotherapy or endocrine therapy without chemotherapy could be associated with different long-lasting physical health declines among breast cancer survivors compared with those without breast cancer, according to a recent study published in JAMA Network Open.
Background
Physical health is the body’s ability to function normally and includes factors such as the ability to carry out activities, daily living, fatigue, and pain.
“Patients with breast cancer [experience] an abundance of long-term and late health effects and are at risk of earlier-onset disease and [a] higher incidence of chronic health conditions,” stressed lead study author Clara Bodelon, MA, MS, PhD, a senior principal scientist of Survivorship Research at the American Cancer Society. “These findings are important because understanding factors related to their physical health decline could lead to interventions to improve their health outcomes,” she added.
Study Methods and Results
In the study, investigators used data from Cancer Prevention Study 3, a prospective cohort that enrolled participants in 35 U.S. states, the District of Columbia, and Puerto Rico between 2006 and 2013. They analyzed the outcomes of 2,566 female patients diagnosed with nonmetastatic breast cancer who returned a survey at least 90 days following their diagnosis and 12,826 age-matched women without breast cancer. The patients with breast cancer had a median age of 56.3 years at diagnosis. Physical health was assessed by investigators using the Patient-Reported Outcomes Measurement Information System Global Health Scale instrument.
The investigators noted that 47.7% (n = 1,223), 10.8% (n = 276), and 24.7% (n = 634) of the patients with breast cancer received endocrine therapy, chemotherapy, or both, respectively. Compared with the women who didn’t have breast cancer, there was a greater physical health decline within 2 years of diagnosis among the breast cancer survivors receiving endocrine therapy, chemotherapy, or both. The decline among the breast cancer survivors who received endocrine therapy was restricted to those receiving aromatase inhibitors. Over 2 years postdiagnosis, the decline was only observed among those who received chemotherapy.
Conclusions
“This is encouraging news for breast cancer survivors. If they do not receive chemotherapy, it is unlikely that they will have long-lasting physical health decline,” underscored Dr. Bodelon. “However, further studies are needed to confirm these results and to better understand the health consequences of these treatments,” she concluded.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
