History of Cancer Linked to Quicker Loss of Physical Function in Post-Menopausal Women
Physical function declined faster in post-menopausal women with a history of breast cancer, colorectal cancer, endometrial cancer, and lung cancer than it did in women with no history of cancer.
The research was published online on Jan. 19, 2023, by the journal JAMA Oncology. Read “Long-term Trajectories of Physical Function Decline in Women With and Without Cancer.”
What is physical function?
Physical function is your ability to do basic daily activities, including:
eating
bathing
getting dressed
going to the bathroom
walking or moving around your living space
caring for yourself
Poor physical function is linked to several health issues, including:
higher risk of falling
lower likelihood of living independently
worse self-reported health
Some research suggests that people with a history of cancer have worse physical function than people with no history of cancer, but it hasn’t been clear how quickly any declines happen after a cancer diagnosis. In this analysis, the researchers wanted to address that gap in knowledge and looked at information collected as part of the Women’s Health Initiative study.
About the Women’s Health Initiative study
Referred to as the Women’s Health Initiative, the study is made up of two parts: the Women’s Health Initiative Clinical Trial and the Women’s Health Initiative Observational Study. Together, the two studies include information from more than 161,808 post-menopausal women who were 50 to 79 years old when they joined between 1993 and 1998:
68,132 women were in the clinical trial
93,676 were in the observational study
In 2005, 115,407 women — about 77% of the women in the study — agreed to an extended follow-up period.
In 2010, 93,567 — about 87% of those who agreed to the first extended follow-up — agreed to another extended follow-up period, which is still in progress.
The Women’s Health Initiative wants to find any links between health problems, such as cancer, and health, diet, and lifestyle factors.
About the analysis
For this analysis, the researchers identified women who had been diagnosed with breast, colorectal, endometrial, and lung cancer and matched them with up to five women who weren’t diagnosed with cancer but were similar in terms of:
age
year of study enrollment
arm of study (clinical trial or observational study)
Overall, the analysis included 9,203 women who had been diagnosed with cancer and 45,358 women with no history of cancer.
Of the women diagnosed with cancer:
5,989 were diagnosed with breast cancer
1,352 were diagnosed with colorectal cancer
980 were diagnosed with endometrial cancer
902 were diagnosed with lung cancer
Some of the women were diagnosed with more than one type of cancer.
For each type of cancer, the researchers looked at:
local cancer (cancer that stays in the organ it starts in, such as the breast)
regional cancer (cancer that spreads into nearby tissue and lymph nodes, but not beyond that area)
The researchers didn’t look at metastatic cancer (cancer that spreads to places in the body away from the original organ). For breast cancer, the most common places of metastatic spread are the liver, lungs, and bones.
The average age of the women with a history of cancer when they were diagnosed was 73.
Women who’d been diagnosed with cancer were more likely than women with no history of cancer to:
be white
smoke or be a former smoker
drink slightly more alcohol
The researchers used a standard tool called the RAND-36 scale to measure the women’s physical function. The scale reports physical function with a score that ranges from 0 to 100.
The Women’s Health Initiative protocol called for the women’s physical function to be measured when they joined the study and again three years later.
The clinical trial also called for the women’s physical function to be measured:
one year after the joined the study
when the study was initially closed, from 2002 to 2004
six years after they joined the study
nine years after they joined the study
All the women who agreed to extended follow-up had their physical function measured annually after 2005.
Overall, the researchers measured physical function in:
71% of women diagnosed with breast cancer
72% of women diagnosed with lung cancer
70% of women diagnosed with colorectal cancer
67% of women diagnosed with endometrial cancer
All the women were measured at least twice before they were diagnosed with cancer and at least twice after being diagnosed with cancer.
There was no difference in physical function between women diagnosed with breast, colorectal, and endometrial cancer before they received their diagnosis and their counterparts who had no cancer history.
In contrast, women who were later diagnosed with lung cancer had physical function scores that were four to five points lower than the women they were matched with before they received their diagnosis.
After being diagnosed, women with a history of cancer had a quicker decline in physical function than the women with no history of cancer.
In the first year after a cancer diagnosis, women who were diagnosed with regional disease or who received chemotherapy had the largest decline in physical function.
Among women diagnosed with regional breast cancer, physical function declined nearly four times faster than women with no history of cancer. Among women diagnosed with local breast cancer, the rate of decline was smaller than it was for women with regional disease, but it was still double the rate of women with no history of cancer.
The rate of physical function loss slowed over time among women diagnosed with cancer. Still, the rapid losses in the year after diagnosis meant that women with a history of cancer had lower physical function scores than women with no history of cancer, even five years after being diagnosed.
Five years after diagnosis, physical function scores were:
0.9 points lower for women diagnosed with local breast cancer than for women with no history of cancer
3.6 points lower for women diagnosed with regional breast cancer than for women with no history of cancer
“Overall, and in the long-term, post-menopausal survivors of cancer have diminished [physical function] compared with matched controls,” the researchers wrote.
What this means for you
Although this study’s results are troubling, the good news is there are steps you can take to help maintain and improve your physical function.
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.
Besides reducing your risk of losing physical function, exercise also can help:
ease fatigue
reduce your risk of heart problems
improve your quality of life
reduce the risk of dying from breast cancer
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!
Learn more about exercise.
— Last updated on February 22, 2023 at 7:13 PM