The acceleration of ageing in older patients with cancer

Muhandiramge, Jaidyn; Orchard, Suzanne G; Haydon, Andrew; Zalcberg, John

doi:10.1016/j.jgo.2020.09.010

Cited by 18 publications

(19 citation statements)

References 111 publications

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“…A decline in functional status is an inevitable part of normal ageing, with the rate of functional decline steadily increasing over a person's lifespan [2]. This decline, however, is accelerated in individuals with cancer, with this cohort experiencing rapid deterioration following a cancer diagnosis and treatment, compared to their cancer-free counterparts [3]. Not only does functional decline impact quality of life, impairment in functional status can also lead to increased comorbidity burden, greater dependency on carers, institutionalisation, and increased mortality [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, assessment of functional status rarely plays a role in the routine clinical care of older patients with cancer, particularly if they are not actively receiving treatment. With an ever-growing population of cancer survivors due to advances in anti-cancer treatment [3], it is vital that functional decline is addressed to ensure that patients with cancer are provided the opportunity to maintain a high quality of life and to live independently.…”

Section: Introductionmentioning

confidence: 99%

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Functional Decline in the Cancer Patient: A Review

Muhandiramge

Orchard

Warner

et al. 2022

Cancers

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A decline in functional status, an individual’s ability to perform the normal activities required to maintain adequate health and meet basic needs, is part of normal ageing. Functional decline, however, appears to be accelerated in older patients with cancer. Such decline can occur as a result of a cancer itself, cancer treatment-related factors, or a combination of the two. The accelerated decline in function seen in older patients with cancer can be slowed, or even partly mitigated through routine assessments of functional status and timely interventions where appropriate. This is particularly important given the link between functional decline and impaired quality of life, increased mortality, comorbidity burden, and carer dependency. However, a routine assessment of and the use of interventions for functional decline do not typically feature in the long-term care of cancer survivors. This review outlines the link between cancer and subsequent functional decline, as well as potential underlying mechanisms, the tools that can be used to assess functional status, and strategies for its prevention and management in older patients with cancer.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional Decline in the Cancer Patient: A Review

Muhandiramge

Orchard

Warner

et al. 2022

Cancers

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“…When adjusted for age, sex and lifestyle factors, cancer survivors are more likely to suffer from chronic diseases, including second cancers, than are their agematched counterparts, possibly due to accelerated biological ageing and treatment-induced adverse events. Thus, not only is ageing a significant risk factor for cancer but cancer and its treatment also significant contribute to ageing, indicating a bilateral relationship [117][118][119]. Hallmarks of accelerated ageing include anatomical, functional and mechanistic effects that are similar to those of ageing but are detected at a younger age than usual [120].…”

Section: Survivorship In Ageing Patients Treated For Cancermentioning

confidence: 99%

Ageing and cancer: a research gap to fill

2022

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The complex mechanisms of ageing biology are increasingly understood. Interventions to reduce or delay ageing-associated diseases are emerging. Cancer is one of the diseases promoted by tissue ageing. A clockwise mutational signature is identified in many tumours. Ageing might be a modifiable cancer risk factor. To reduce the incidence of ageing-related cancer and to detect the disease at earlier stages, we need to understand better the links between ageing and tumours. When a cancer is established, geriatric assessment and measures of biological age might help to generate evidencebased therapeutic recommendations. In this approach, patients and caregivers would include the respective weight to give to the quality of life and survival in the therapeutic choices. The increasing burden of cancer in older patients requires new generations of researchers and geriatric oncologists to be trained, to properly address disease complexity in a multidisciplinary manner, and to reduce health inequities in this population of patients. In this review, we propose a series of research challenges to tackle in the next few years to better prevent, detect and treat cancer in older patients while preserving their quality of life.

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“…Aging is therefore widely accepted to be a strong risk factor for cancer [ 3 ]. However, aging processes may also be accelerated as a result of cancer and cancer treatment [ 4 •, 5 ]. The functional outcomes of aging, sometimes referred to as clinical manifestations of aging, include various deficits such as functional decline, frailty, cognitive impairment, and chronic disease [ 4 •, 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, aging processes may also be accelerated as a result of cancer and cancer treatment [ 4 •, 5 ]. The functional outcomes of aging, sometimes referred to as clinical manifestations of aging, include various deficits such as functional decline, frailty, cognitive impairment, and chronic disease [ 4 •, 5 ]. One important clinical manifestation of aging not often linked with cancer is cardiovascular disease (CVD) [ 6 ], a common group of disorders that typically encompass cardiac disease, arterial disease, and cerebrovascular disease (i.e.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Disease in Adult Cancer Survivors: a Review of Current Evidence, Strategies for Prevention and Management, and Future Directions for Cardio-oncology

et al. 2022

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Purpose of Review Cardiovascular disease is long-term complication of both cancer and anti-cancer treatment and can have significant ramifications for health-related quality of life and mortality. This narrative review explores the current evidence linking cardiovascular disease and cancer, as well as exploring strategies for the prevention and management of cardiovascular disease, and outlines future opportunities in the field of cardio-oncology. Recent Findings Cancer confers risk for various cardiovascular diseases including heart failure, cardiomyopathy, arrhythmia, coronary heart disease, stroke, venous thromboembolism, and valvular heart disease. Cancer treatment, in particular agents such as platinum-based chemotherapy, anthracyclines, hormonal treatments, and thoracic radiotherapy, further increases risk. While cardiovascular disease can be identified early and effectively managed in cancer survivors, cardiovascular screening and management does not typically feature in routine long-term cancer care of adult cancer survivors. Summary Cancer and cancer treatment can accelerate the development of cardiovascular disease. Further research into screening and management strategies for cardiovascular disease, along with evidence-based guidelines, is required to ensure adult cancer survivors receive appropriate long-term care.

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The acceleration of ageing in older patients with cancer

Cited by 18 publications

References 111 publications

Functional Decline in the Cancer Patient: A Review

Functional Decline in the Cancer Patient: A Review

Ageing and cancer: a research gap to fill

Cardiovascular Disease in Adult Cancer Survivors: a Review of Current Evidence, Strategies for Prevention and Management, and Future Directions for Cardio-oncology

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