Communication between health-care providers and older patients with cancer regarding the significance of physical activity may help reduce the risk of falls during cancer therapy, according to new findings presented by Lu and Zheng at the 2024 ASCO Quality Care Symposium (Abstract 224).
Background
“While falls can happen to anyone at any time, the risk is higher in [patients] with cancer, particularly during the all-consuming period of cancer treatment. This is especially worrisome for older patients, who often have poorer outcomes following a fall. There is increasing awareness among clinicians of the importance of discussing methods to reduce the risk and avoid consequential outcomes from falls, specifically by promoting physical activity to their older patients,” emphasized lead study author Chuan Lu, MD, MPH, of Dana-Farber Cancer Institute. “However, there is limited understanding of how well this information is communicated to older patients. This study was designed to help reveal the realities of physician-patient interactions about physical activity to prevent falls in real-world clinical settings,” she added.
Study Methods and Results
In the new study, investigators examined the data of over 100,000 patients aged over 65 years with cancer who were who were enrolled in Medicare between 2018 and 2022 and undergoing cancer therapy during the study period.
The investigators found that the incidence of falls remained at about 30% among the patients. Just over 50% (a median of 56.8%) of them recalled starting a conversation with their health-care providers about using physical activity as a method for preventing falls. A smaller percentage (a median of 51.4%) of the patients recalled receiving advice from their physicians to increase physical activity in an effort to lower their risk of falls.
After further analysis, the investigators revealed that the patients who initiated a conversation or received advice about physical activity from their physicians demonstrated a lower risk of falling. Overall, those who proactively started a conversation with their health-care providers had a 21.4% lower risk of falling. Those who received advice from their health-care providers to increase their physical activity had a 21.6% lower risk of falling.
When analyzing data based on specific cancer types, the investigators discovered that the patients with lung cancer, colorectal cancer, or prostate cancer who had conversations about physical activity had a lower risk of falls. They noted that the findings could partly be explained by the higher baseline risk of falls in these patients as a result of the location of the cancer and the standard treatments used.
For instance, colorectal and lung cancers may directly impact cardiopulmonary or digestive functions that are essential to maintain physical activity level and could lead to an increased risk of falls—as could complications from cancer surgery. Among patients with prostate cancer, physical function may be affected by radiation therapy or hormone therapy. As a result, the investigators suggested that conversations regarding physical activity may be even more crucial.
Conclusions
The investigators plan to investigate potential barriers and other factors that may contribute to falls and fall-related injuries in older patients with cancer undergoing active treatment at the health-care system, health-care provider, and patient levels.
“This study demonstrated a 21% reduction in the risk of falls among patients older than 65 who spoke to their [physicians] about physical activity. While we do not know how much or what type of activity the patients were doing, this study highlights that counseling about physical activity may reduce fall risk. Physical activity has many other benefits as well and should be considered as part of routine oncologic care,” concluded Eleonora Teplinsky, MD, a medical oncologist at the Valley Health System.
Disclosure: For full disclosures of the study authors, visit meetings.asco.org.
