Cancer Can Exacerbate Existing Health Problems and Accelerate Age-Related Functional Decline

How great the impact cancer has on exacerbating existing health problems or even creating new health problems in older adults is not well understood.  It is estimated that by 2030, almost 1 in every 5 Americans will be over the age of 65.  According to a recent report provided by the American Cancer Society, the number of older adults diagnosed with cancer will grow from 61% to 70% by 2030. It is common for older cancer survivors to experience additional age-related health conditions, including functional decline, joint problems, sensory impairment, and urinary incontinence.  With the ever-growing older adult population, the need to investigate this unanswered question of how cancer effects health status and what strategies need to be developed to enhance health outcomes become more pertinent.

What is understood about the effect cancer has on health status and functioning in older adults is that cancer is associated with a high prevalence of a variety of other health conditions such as incontinence, functional limitations, hearing difficulties, falls, depression, lower self-reported health, and higher rates of frailty. Furthermore, a study that evaluated a large population of cancer patients found that the existence of established comorbid conditions rather than a history of cancer was related to a decreased ability to perform activities of daily living (e.g., bathing, eating, dressing toileting) independently.

Nonetheless, little is known about the independent effects of cancer compared to normal signs of aging due to a lack of prediagnosis health data and general research on this complex topic.  A recent study published in the Cancer journal explored the direct cancer had on physical functioning and performance of activities of daily living. The study also sought to discover whether cancer raised the risk of developing age-related health problems that include sensory impairment, depressive mood, arthritis, and urinary incontinence.  Lastly, the study examined whether cancer worsens preexisting health problems of older adults.

The study examined 921 older adult participants split into two groups: one group consisted of participants diagnosed with breast, colon, lung, or prostate cancer, and the other group consisted of controls.  Changes in both groups’ physical function and performance on activities of daily living were observed and compared. The study found that participants with cancer showed greater loss in physical function and decrease in the ability to perform activities of daily living compared with controls.  The greatest changes were seen in patients suffering with lung cancer.

The study also found that the risk of having depression increased with cancer diagnosis, although the risks for urinary incontinence, arthritis in the hands and hips, sight and hearing problems did not change.  Cancer diagnosis also did not correlate with a greater severity of joint or food neuropathy.

The findings from this study suggest that cancer has a strong influence on declining physical functioning and increasing the risk of depression in elderly individuals. There is a need for more research in order to find the right interventions to decrease these risks and improve patient outcomes.  Health care providers need to prepare patients and their loved ones for declines in functioning capacity and interventions that delay the declines for senior patients with cancer are needed.