Investigators have found that female patients aged 65 years or older with high-risk breast cancer who are treated with chemotherapy may be more likely to experience a substantial decline in physical function, according to a recent study published by Sedrak et al in the Journal of Cancer Survivorship.
Background
Breast cancer has been known to lead to faster aging and declining physical abilities, especially in older female patients. This phenomenon of accelerated aging can have deleterious effects on patients’ quality of life, independence, and lifespan. High-risk breast cancer includes cancers in more advanced stages and with less favorable molecular characteristics.
“We have previously shown that chemotherapy can contribute to a decline in physical function in breast cancer survivors, but it wasn’t fully understood if the decline was primarily driven by the cancer, chemotherapy, or both,” stressed lead study author Mina Sedrak, MD, MS, Associate Professor of Medicine at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and Director of the Cancer and Aging Program at the UCLA Health Jonsson Comprehensive Cancer Center. “It’s important to have this comparison to determine whether or not this decline represents an acceleration of the aging process itself,” he added.
Because the number of older breast cancer survivors is expected to rise to more than 6 million by 2040, understanding the mechanisms of accelerated aging and identifying strategies to prevent it may be imperative.
Study Methods and Results
In the recent multicenter prospective study, the investigators compared the changes in physical function over time in 444 older female patients with early-stage breast cancer who received chemotherapy, 98 female patients with early-stage breast cancer who didn’t receive chemotherapy, and 100 age-matched controls without cancer—with the goal of better understanding the impact of breast cancer treatment on aging-related functional decline.
The patients involved in the study underwent two evaluations, the first of which included completing questionnaires about demographics, health status, and a geriatric assessment. For the patients with breast cancer, additional data on cancer-specific and treatment-related characteristics were gathered from their medical records. The second evaluation included another round of the geriatric assessment and occurred within 30 days of ending chemotherapy for the patients who received chemotherapy or at matched time points for the other two groups.
The investigators discovered that over 30% of the patients who underwent chemotherapy experienced a significant functional decline in their ability to perform daily tasks compared with 8% of those who didn't receive chemotherapy and 5% controls. Further, among the patients who experienced substantial functional declines, the activities most adversely affected were climbing several stairs (75.7%), walking 1 mile (73.0%), and engaging in moderate activity (68.6%).
Conclusions
The recent findings indicated that the combination of high-risk breast cancer and chemotherapy may contribute to accelerated decline in older patients with early-stage breast cancer.
The investigators are currently focusing on analyzing the biological mechanisms underlying the interaction between cancer treatment and fundamental aging processes. They are specifically focusing on cellular senescence and identifying mechanisms that can be targeted by drugs to potentially reverse these processes.
“Our findings emphasize the impact that cancer and cancer treatment can have on physical function in older [female patients],” underscored Dr. Sedrak. “Physical function is essential for maintaining independence, mobility, and overall quality of life; and there needs to be a more urgent effort to develop interventions and strategies to preserve physical function for [female patients] before, during, and after cancer treatment,” he concluded.
Disclosure: The research in this study was funded in part by the National Institute of Aging and the Breast Cancer Research Foundation. For full disclosures of the study authors, visit link.springer.com.
