Study: Identify Risk Factors in Women with Breast Cancer to Minimize Chemo-Related Functional Decline

Older women undergoing chemotherapy for breast cancer have a higher risk of experiencing a decline in their ability to function physically, according to a new study in the Journal of the American Geriatrics Society.

The effect of chemotherapy on functional status can be critical for older adults, as declining function can inhibit the ability to live independently and perform daily activities. Additionally, previous studies have shown that older individuals with breast cancer who demonstrated a decline in physical function in the first 2 years after diagnosis had poorer 10-year survival.

For the study, the researchers aimed to detect common changes in patients’ ability to perform daily activities after receiving chemotherapy and to pinpoint why some women recovered their ability to function normally and others did not.

To accomplish this, the researchers analyzed data from a previous study that included 635 women aged 65 years or older who had been diagnosed with breast cancer.

The researchers asked the study participants the following questions:

• Do you have trouble with strenuous activities, like carrying a heavy shopping bag?
• Do you have any trouble taking a long walk?
• Do you have any trouble taking a short walk outside the house?
• Do you need to stay in bed or in a chair during the day?
• Do you need help with eating, dressing, washing yourself, or using the toilet?

According to the findings, short-term decline in physical function appeared to be common among older adults treated with chemotherapy. Forty-two percent of patients reported a decrease in their ability to function from pre-chemotherapy to the end of treatment and 30% experienced a decline in their ability to function from before they started treatment to 12 months later.

Among the patients who experienced physical function decline from the beginning to end of treatment, some returned to their normal functioning levels. According to the study, 47% of patients recovered to the activity level they previously had within 12 months after starting chemotherapy.

“In our study, about half of the patients who experienced functional decline were able to ‘bounce back’ to their former function, and we considered them to be physically resilient,” the researchers wrote. “We also learned that half of the patients were resistant to decline and maintained their functional status throughout treatment.”

Based on their findings, the researchers identified risk factors for functional decline 1 year after chemotherapy as fatigue, having difficulty breathing, being unmarried or lacking social support, and poor appetite, which could indicate poor nutrition and/or depression. They noted that encouraging diet and exercise programs and behavior interventions for older adults being treated with chemotherapy could help increase their ability to recover functioning abilities.

“This study provides insight into the incidence of functional decline in older adults with breast cancer receiving adjuvant chemotherapy, a group that has been understudied,” the researchers concluded in the study. “It also provides insight into potential risk factors for functional decline and lack of resilience that can be targeted for interventions.”

References

Hurria A, Soto-Perez-de-Celis E, Allred JB, et al. Functional decline in resilience in older women receiving adjuvant chemotherapy for breast cancer. Journal of the American Geriatrics Society. 2018. https://doi.org/10.1111/jgs.15493

Does Chemotherapy Harm Ability to Function for Older Women with Breast Cancer [research summary]. Health in Aging’s website. https://www.healthinaging.org/blog/does-chemotherapy-harm-ability-to-function-for-older-women-with-breast-cancer/. Accessed August 29, 2018.