Women of All Ages with Breast Cancer Experience the Same Levels of Symptom Severity

Both older and younger women with early breast cancer (EBC) being treated with the same chemotherapy experienced around the same levels of symptom severity and symptom-related adverse events, according to a study published in Cancer.

It was unknown whether there was patient-reported symptom severity and symptom interference with daily activities difference in women under the age of 65 and women above the age of 65, with both groups receiving the same chemotherapy treatment for EBC. The objective of the study was to expand knowledge and information on chemotherapy tolerability on different age brackets.

This study was a contributing analysis of data from 3 other studies that investigated self-directed walking during chemotherapy for EBC.

The study consisted of 284 women with EBC, 163 patients were older than 63 years and the remaining 121 patients were aged 65 years or younger. During chemotherapy treatment patients rated 17 different symptoms: fatigue, insomnia, anxiety, depression, dyspnea, peripheral neuropathy, joint pain, muscle pain, abdominal pain, general pain, edema of the extremities, constipation, diarrhea, nausea, vomiting, mucositis and hot flashes.

Results showed in symptom severity that a higher percentage of younger women, 49%, receiving an anthracycline based regimen, experiences moderate, severe, or very severe (MSVS) hot flashes, compared to the older group in which only 18% reported this same symptom. For a nonanthracycline regimen the younger group of women still reported MSVS hot flashes compared to the older group, 38% vs. 19%, and a higher percentage of older women reported MSVS arthralgia, 49% vs. 28%.

Overall, both younger and older patients reported that symptom severity was higher than symptom interference. A higher percentage of younger who were being treated with anthracycline based regimen reported MSVS hot flashes (32% vs. 18%) and muscle pain (38% vs. 18%). For nonanthracycline based regimens, more younger women still reported MSVS hot flashes, 26% vs. 9%, but more older women reported abdominal pain, 28% vs. 13% respectively.

Researchers were not surprised that hot flashes were a bigger concern and side effect in younger women, specifically those who were premenopausal or perimenopausal at the time of diagnosis.

Overall, this study found little difference between older and younger women being treated with chemotherapy for EBC in regard to symptom severity and symptom inference with everyday life. It was also reported that both older and younger women find the symptom severity more concerning than symptom interference.

“It is perhaps easier for patients to communicate that a symptom is interfering with their daily activities rather than convey the absolute severity of a symptom, which may explain why clinicians are reported to often underestimate actual symptom intensity,” the authors concluded.