Breast Cancer Chemo May Make Everyday Activities Harder for Older Women
Being able to do such daily activities as walking, climbing stairs, bathing, and dressing are important for mobility, independence, and quality of life.
A study in the Journal of Cancer Survivorship found that older women with early-stage breast cancer may experience more problems with these types of activities while being treated with chemotherapy than women who don’t receive chemotherapy. The study highlights the importance of tailored programs to support the activity of people during and after chemo.
Key takeaways
More than 30% of women 65 and older who received breast cancer chemotherapy saw their physical function decline by a lot, compared to 8% of women who didn’t receive chemotherapy, and 5% of women who hadn’t been diagnosed with cancer.
The ability to climb stairs, walk one mile, and do moderate activity was most affected.
Women who received an anthracycline medicine, like Adriamycin (chemical name: doxorubicin) or a chemo regimen that included a taxane, like Taxol (chemical name: paclitaxel) and Herceptin (chemical name: trastuzumab) had larger drops in physical function than those treated with only a taxane.
What the results mean for you
Research suggests that poor physical function in older people is linked to a higher risk of falling, poorer mental health and overall health, and a lower likelihood of independent living. If you are noticing that you’ve been having a hard time with daily activities since starting chemotherapy, talk with your healthcare team. They may be able to adjust your chemo or recommend small steps you can take to improve your physical function (for example, through your diet or light exercise).
About the study
An earlier study found that more than 40% of older women who receive chemotherapy after breast cancer surgery had a decline in physical function. The researchers from that study wanted to know more so they designed a study to answer the question: Is physical decline in these women mainly because of the breast cancer diagnosis, the chemotherapy, or a combination of both?
Called HOPE (Hurria Older PatiEnts), the study included three groups of women ages 65 and older:
444 women were diagnosed with early-stage breast cancer, had had surgery, and were receiving chemotherapy
98 women were diagnosed with early-stage breast cancer, had had surgery, and were not receiving chemotherapy
100 women had not been diagnosed with cancer
The researchers evaluated all the women in the study twice:
when they joined the study, or within the 14 days before chemotherapy started for the chemotherapy group
within 30 days of completing chemotherapy or a matched time point three, four, or six months after the first visit for the two groups not receiving chemotherapy
At each evaluation, the researchers assessed the women’s physical and cognitive function, weight and height, and body mass index.
The women also filled out questionnaires that asked about their ability to do the activities of daily living, history of falling, social support, and more. For women diagnosed with breast cancer, the researchers also collected information on treatment.
Based on the results of the assessments, the researchers gave each woman a physical function score ranging from zero to 100 at each evaluation.
Detailed results
At the first evaluation, each group had similar function scores. Average scores were:
79.3 for the women receiving chemotherapy
81.4 for the women not receiving chemotherapy
81.8 for the women without cancer
At the second evaluation months later, the women receiving chemotherapy had a noticeable drop in function scores, while the other two groups didn’t. Average scores were:
68.9 for the women receiving chemotherapy
80.9 for the women not receiving chemotherapy
81.9 for the women without cancer
The researchers then looked at the number of women in each group who had a large decline in physical function:
34.7% of women receiving chemotherapy had a large drop in physical function
8.2% of women not receiving chemotherapy had a large drop in physical function
5% of women without cancer had a large drop in physical function
Nearly 75% of the women who received chemotherapy and experienced a large drop in physical function said they found stair climbing and walking a mile most affected.
The researchers also looked to see if different chemotherapy regimens affected physical function.
Women who received an anthracycline medicine, like Adriamycin or a regimen that included a taxane, like Taxol, and Herceptin were more likely to have a large drop in physical function than women who received only a taxane. Two other regimens were linked to a higher likelihood of physical decline:
a taxane, plus Herceptin, plus a platinum-based medicine, like carboplatin
a taxane, plus an anthracycline, plus Herceptin
“Our findings emphasize the impact that cancer and cancer treatment can have on physical function in older women,” first author Mina Sedrak, MD, MS, associate professor of medicine at the David Geffen School of Medicine and director of the Cancer and Aging Program at the UCLA Health Jonsson Comprehensive Cancer Center, said in a statement. “[T]here needs to be a more urgent effort to develop interventions to develop strategies to preserve physical function for women, before, during and after cancer treatment.”
Learn more
One of the best ways is exercise. Aerobic exercises, such as walking, jogging, or bike riding, can help build your stamina and endurance so you don’t tire as quickly when doing your daily activities. Strength or resistance exercises can help you maintain and build muscle mass and make your daily activities easier to do. Examples include weight lifting and resistance band exercises. Flexibility exercises, such as stretching or yoga, can help improve the range of motion of your joints and also reduce stress.
Besides reducing your risk of losing physical function, exercise also can help:
Still, if you’re currently receiving treatment, finding the motivation and time to exercise nearly every day can be tough, especially when you have to balance it with all the other things you have to do.
Starting slowly and then gradually increasing the time and intensity you exercise can help, especially if you’ve never exercised before. Walking for 15 to 20 minutes a day can be a good way to start. Slow bike riding or gentle stretching are also good options for beginners.
Walking or doing another type of exercise with a friend can give you the motivation you need to carve out some time to be active each day. Plus, you can socialize at the same time.
It’s never too late to get moving. And once you start, keep at it!
Sedrak, M.S., Sun, CL., Bae, M. 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. J Cancer Surviv (2024).
— Last updated on December 27, 2024 at 7:10 PM