Cancer Linked With Health Decline As Patients Age

A new study from researchers at the American Cancer Society showed that as cancer survivors age, they have greater declines in certain physical health conditions, as well as an increased risk for depression compared with people who do not have cancer. The declines seen in cancer survivors were beyond those typically considered to be part or normal aging, according to Corinne R. Leach, PhD, of the Behavioral Research Center at the American Cancer Society, and colleagues.

“Decreased physical functioning among older cancer patients is an important finding for clinicians because it is also actionable,” Leach and colleagues wrote. “Health care providers need to recommend interventions that preserve physical function to limit the declines for older cancer patients, such as home-based diet and exercise.”

The researchers used linked data from the SEER registry and Medicare Health Outcomes Survey on 921 Medicare beneficiaries with breast, colorectal, lung, or prostate cancer and compared it with data from 4,605 cancer-free controls.

Physical health was measured using the SF-36 PCS. At baseline, controls had a PCS score of 43.4 compared with a range of 44.9 for prostate cancer survivors to 40.6 for lung cancer survivors. The analysis showed that at follow-up, all cancer survivors had significant decreases in excess of the defined two-point decrease that represented a minimally important difference. Survivors of lung cancer had the greatest change in PCS from baseline to follow-up with a decrease of 6.72 points.

The study also looked at specific activities of daily living. The greatest changes to these activities were also found in lung cancer patients. At baseline, 12% of patients with lung cancer reported difficulty with bathing compared to 22% at follow-up. For dressing, the change was from 8% at baseline to 19% at follow-up; for eating, 5% to 14%; and for getting in/out of chairs, 12% to 34%.

In addition to these physical changes, the study also showed that a cancer diagnosis increased the risk for depression. Specifically, patients who had colorectal cancer (odds ratio [OR], 1.75; 95% CI, 1.21–2.52) or prostate cancer (OR, 1.47; 95% CI, 1.08–1.98) had a higher risk for major depressive disorder at follow-up compared with the control group.

No significant differences were found between the two groups for the risk of developing arthritis in the hand/hip, incontinence (except for prostate cancer survivors), or vision/hearing problems.

“Health care providers need to improve the coordination of care so that patients and families are prepared for the change in functioning levels,” the researchers concluded.