Physical Function May Decline in Women After Cancer Diagnosis, Throughout Survivorship

Postmenopausal female cancer survivors may be more likely to experience accelerated declines in physical function following their initial diagnosis, which persisted after treatments have concluded compared to women without cancer at the same age, according to a recent study.

“This information can inform management decisions in postmenopausal women with common cancers,” the researchers wrote in the study published in JAMA Oncology. “Future studies to define predictors of (physical function) trajectories could inform identification of populations for early interventions to mitigate (physical function) decline.”

In the study’s introduction, researchers defined aging as physical function deficits that may impact daily life. This decline may be associated with falls, poorer self-reported health and a diminished ability to live independently. Previous studies in this space demonstrated the decline of physical function during and after cancer treatment.

Researchers compared the health data of postmenopausal women 59 to 70 years old, which included 9,203 patients with cancer and 45,358 women without the disease. The cancer types included in this study include breast (5,989 patients), colorectal (1,352 patients), endometrial (980 patients) and lung (902 patients).

Physical function was evaluated by moderate/vigorous activities, strength, walking abilities and self-care capabilities. Researchers took several factors into consideration with this scale including cancer treatment effects, socioeconomic status, lifestyle decisions such as drinking or smoking, diabetes and body mass index.

Data show that women who died within five years of receiving their diagnosis experienced a drastic decline in physical function in the first year after diagnosis, while patients who went on to survive their disease had relatively normal physical function comparable to peers in the control group at that point. However, physical function decline did ultimately impact long-term survivors. In particular, longer-term rates of physical function decline were accelerated between one to 10 years after diagnosis. This resulted in an estimated physical function that was significantly lower than those without cancer. This was the fact even five years after diagnosis.

Changes in physical function scores were more significant if cancer spread beyond the site of initial diagnosis or for any patient who received a cancer treatment that impacts the entire body instead of the initial disease site (such as chemotherapy. Women with localized breast cancer had a smaller rate of physical function decline immediately after diagnosis, although this was double the rate among women without cancer. Researchers noted that this is “representing a statistically significant acceleration.”

While the study authors initially questioned whether patients with cancer would experience a short-term physical function decline then progress at the rate of their peers, the data proved survivors of cancer experience a steep long-term decline after the initial decrease in physical function associated with treatment.

“These initial accelerations (in declines) meant that survivors of most cancer types had estimated (physical function) significantly below that of age-matched controls even at five years postdiagnosis,” the study authors wrote.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.