The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors

Abstract

BACKGROUND:The majority of cancer survivors are aged !65 years, yet, historically, cancer research has focused infrequently on older patients. The objective of this study was to examine predictors of physical function within a framework that integrates the gerontologic and oncologic needs of older cancer survivors. METHODS: Path analysis tested 759 women who were breast cancer survivors aged !70 years from the American Cancer Society Study of Cancer Survivors II to examine the cancer, aging, and personal characteristics that had an impact on symptoms and physical functioning. INTRODUCTIONApproximately 11.9 million people in the United States are living with a history of cancer, and over 7 million survivors are in the group aged !65 years. 1 The aging of the US population is expected to contribute to the predicted exponential increase in older cancer survivors in the near future. Surprisingly little research has examined issues of cancer survivorship in the elderly, 2-5 but more comorbidities and poorer quality of life, functional status, and general health have been reported. [6][7][8][9][10] A previously reported conceptual model 11 proposed a holistic approach to gero-oncology survivorship research. It hypothesized direct and indirect relations of cancer-specific variables (eg, disease stage, treatment, length of survivorship, and symptoms), personal characteristics, lifestyle behaviors, and aging-related concerns (eg, psychosocial support and comorbidity) on health outcomes for older cancer survivors. The conceptual model was revised to reflect the chosen outcome measure and selected variables. The purpose of this study was to evaluate the revised model (Fig. 1) by examining the influence of factors associated with aging, cancer, symptom bother, and individual characteristics on the important outcome of physical functioning in older survivors of breast cancer.

The magnitude and characteristics of the population of cancer survivors: using population-based estimates of cancer prevalence to inform service planning for survivorship care

“…They also have high levels of psychological distress related to the continuing effects of cancer and its treatment, significant limitations in physical functioning, and higher rates of frailty than the general population [41–43]. These issues are inter-related and may be exacerbated by lifestyle factors [42, 44]. Our results therefore suggest that follow-up and after-care services for survivors of bladder, colorectal and lung cancer, in particular, should be linked closely to geriatric and other non-cancer specialties, and should be broad ranging.…”

Co-morbidity and predictors of health status in older rural breast cancer survivors

“…Advances in treatment have led to excellent survival and longer life expectancy (Fenlon et al 2013). However, older women with co-morbid conditions and breast cancer represent a growing population who may be living longer, but not necessarily better after completion of successful cancer therapy (Fenlon et al 2013; Bellury et al 2012; Ganz et al 2003). Decline in physical function, increased social isolation, and diminished economic resources may increase vulnerability among older breast cancer survivors (Extermann 2007; Girones et al 2010; Sehl et al 2013; Steptoe et al 2013).…”

“…Among older breast cancer survivors, arthritis, hypertension, diabetes, and overweight/obesity are most frequently reported (Bellury et al 2012; Weaver et al 2013). The greater the number of co-morbid conditions is associated with poor functional ability, increased symptoms, declining overall general health and quality of life, and increase in the number of physician visits (Bellury et al 2012; Bellury et al 2013; Deimling et al 2009; Hays et al 2013; Kurtz et al 2005; Yoon et al 2008).…”

“…Among older breast cancer survivors, arthritis, hypertension, diabetes, and overweight/obesity are most frequently reported (Bellury et al 2012; Weaver et al 2013). The greater the number of co-morbid conditions is associated with poor functional ability, increased symptoms, declining overall general health and quality of life, and increase in the number of physician visits (Bellury et al 2012; Bellury et al 2013; Deimling et al 2009; Hays et al 2013; Kurtz et al 2005; Yoon et al 2008). Social support mediates physical and mental health status in older adults (Lachman & Agrigoroaei 2010; Seeman 2000; White et al 2009); and refers to real or perceived resources provided by others that enable a person to feel cared for, valued, and part of a network of communication and mutual obligation (Stroebe 2000).…”

Assessment of the status of A National Action Plan for Cancer Survivorship in the USA

“…Survivors encounter many issues that fall outside the immediate scope and responsibility of their cancer treatment team-often years after treatment [7][8][9][10]. Survivors may face needs associated with rehabilitation [11][12][13], information [14,15], psychological functioning [16,17], finances [18], and aging [19,20].…”