A study led by UCLA suggests that older adults aged 65 or older with high-risk breast cancer who undergo chemotherapy are more prone to experiencing a significant decline in physical function. This research, published in a special issue of the Journal of Cancer Survivorship, reveals that over 30% of older women diagnosed with early-stage breast cancer and treated with chemotherapy encountered a notable reduction in their ability to perform daily activities such as walking or climbing stairs, compared to those who did not undergo chemotherapy and women of the same age without cancer.
This study stands as the first of its kind to contrast the functional decline in elderly individuals with early-stage breast cancer undergoing chemotherapy against breast cancer patients who did not receive chemotherapy, as well as age-matched women without cancer. Dr Mina Sedrak, the study’s first author and an associate professor of medicine at the David Geffen School of Medicine at UCLA, highlights the importance of this comparison in understanding whether such decline signifies an acceleration of the ageing process itself.
Breast cancer, particularly in older women, often leads to accelerated ageing and a decline in physical abilities. This phenomenon, termed accelerated ageing, can significantly impact individuals’ quality of life, independence, and even lifespan. Given the projected increase in the number of older breast cancer survivors — expected to surpass 6 million by 2040 — comprehending the mechanisms of accelerated ageing and devising strategies to mitigate it becomes paramount.
To delve deeper into the repercussions of breast cancer treatment on ageing-related declines in physical function, the researchers conducted a multicenter prospective study. They compared changes in physical function over time in women aged over 65, involving 444 women with early-stage breast cancer receiving chemotherapy, 98 receiving non-chemotherapy treatments, and 100 women without cancer of similar age.
Participants underwent two assessments: completing questionnaires on demographics and health status and a geriatric assessment. For breast cancer patients, additional data on cancer-specific and treatment-related characteristics were obtained from medical records. The second assessment, including another round of the geriatric evaluation, occurred within 30 days of completing chemotherapy for the chemotherapy group or at matched time points for the other two groups.
The analysis revealed that 30% of elderly adults receiving chemotherapy for breast cancer experienced a significant decline in physical function, compared to 8% among those who did not receive chemotherapy and 5% among those without cancer. Among those experiencing a notable decline, climbing stairs was the activity most adversely affected (75.7%), followed by walking one mile (73.0%) and engaging in moderate activity (68.6%).
These findings suggest that the combination of high-risk breast cancer and chemotherapy contributes to an accelerated decline in physical function among older adults with early-stage breast cancer. Dr. Sedrak emphasizes the impact of cancer and its treatment on physical function in older women, underscoring the importance of preserving physical function throughout the cancer journey.
The research team now aims to elucidate the biological mechanisms underlying the interplay between cancer treatment and fundamental ageing processes. Specifically, they are investigating cellular senescence and identifying mechanisms that could be targeted by drugs to potentially reverse these processes, offering hope for improving the quality of life for elderly breast cancer patients.
More information: Mina S. Sedrak et al, Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study, Journal of Cancer Survivorship. DOI: 10.1007/s11764-024-01594-3
Journal information: Journal of Cancer Survivorship Provided by University of California, Los Angeles
