UCSF - Kaiser - GHN
--Breast cancer victims not only have to face life-and-death decisions
about treatment along with the emotional impact of scarring, but
research tells us their physical limitations put them at risk for poor
health.
--Breast cancer victims not only have to face life-and-death decisions
about treatment along with the emotional impact of scarring, but
research tells us their physical limitations put them at risk for poor
health.
Since basic physical
limitations of breast cancer survivors can impact the amount and type of
exercise as well as daily activities of living they can perform, the consequences can be
serious and actually affect how long a patient lives researchers tell us.
limitations of breast cancer survivors can impact the amount and type of
exercise as well as daily activities of living they can perform, the consequences can be
serious and actually affect how long a patient lives researchers tell us.
UCSF and Kaiser provide the following information: According to a new study published online in “The Journal of the National Cancer Institute,”
breast cancer survivors with functional limitations, an inability to
perform normal daily activities, caused by the disease or its treatment
are more likely to die because of overall poorer health.
breast cancer survivors with functional limitations, an inability to
perform normal daily activities, caused by the disease or its treatment
are more likely to die because of overall poorer health.
The
scientists found that survivors who reported physical limitations after
breast cancer treatment have the same risk of dying from breast cancer
as those without limitations but are more likely to die from other
diseases. In particular, investigators found that older women, as well
as overweight breast cancer patients, were more likely to experience
functional impairments for at least 18 months after treatment.
scientists found that survivors who reported physical limitations after
breast cancer treatment have the same risk of dying from breast cancer
as those without limitations but are more likely to die from other
diseases. In particular, investigators found that older women, as well
as overweight breast cancer patients, were more likely to experience
functional impairments for at least 18 months after treatment.
The
research, the first of its kind, points to risk factors where, with
simple modifications in habits that allow more physical activity, health
might be greatly improved.
research, the first of its kind, points to risk factors where, with
simple modifications in habits that allow more physical activity, health
might be greatly improved.
The
impairments, affecting motion, strength and dexterity, include an
inability to kneel, to lift items heavier than 10 pounds or to handle
small objects, to stand in place, to sit for long periods, to walk up
and down a flight a stairs, to walk two or three city blocks.
impairments, affecting motion, strength and dexterity, include an
inability to kneel, to lift items heavier than 10 pounds or to handle
small objects, to stand in place, to sit for long periods, to walk up
and down a flight a stairs, to walk two or three city blocks.
“Our
study provides evidence of why it is important to develop interventions
that improve physical function, to mitigate the adverse effects of
physical limitations,’’ said Dejana Braithwaite, PhD, first author of
the study and assistant professor of Cancer Epidemiology at UCSF’s Helen
Diller Family Comprehensive Cancer Center. “Intervention strategies –
on the part of the individual, the community and the health provider –
should emphasize physically active lifestyles.’’
study provides evidence of why it is important to develop interventions
that improve physical function, to mitigate the adverse effects of
physical limitations,’’ said Dejana Braithwaite, PhD, first author of
the study and assistant professor of Cancer Epidemiology at UCSF’s Helen
Diller Family Comprehensive Cancer Center. “Intervention strategies –
on the part of the individual, the community and the health provider –
should emphasize physically active lifestyles.’’
Braithwaite
collaborated with researchers at the Kaiser Permanente Northern
California, the University of Utah, the University of California and
Brock University in Canada.
collaborated with researchers at the Kaiser Permanente Northern
California, the University of Utah, the University of California and
Brock University in Canada.
“When
we talk about improving physical function, we are talking about
improving a woman’s ability to perform normal functions of everyday
life, like walking around the block, getting up easily from a chair or
carrying a heavy bag of groceries,’’ said Bette Caan, DRPH, senior
author and principal investigator of the Life After Cancer Epidemiology
Study and Senior Research Scientist at Kaiser Permanente Division of
Research. “These activities appear to make a difference in a woman’s
chance of survival after a breast cancer diagnosis.’’
we talk about improving physical function, we are talking about
improving a woman’s ability to perform normal functions of everyday
life, like walking around the block, getting up easily from a chair or
carrying a heavy bag of groceries,’’ said Bette Caan, DRPH, senior
author and principal investigator of the Life After Cancer Epidemiology
Study and Senior Research Scientist at Kaiser Permanente Division of
Research. “These activities appear to make a difference in a woman’s
chance of survival after a breast cancer diagnosis.’’
With better detection and treatment, more breast cancer patients are surviving longer.
According
to the National Cancer Institute, an estimated 2.5 million women with a
history of breast cancer were alive in 2006 – most of them cancer-free.
The overall five-year survival rate for localized breast cancer is 98
percent, reports the American Cancer Society, while the survival rate
for breast cancer that has spread to the chest wall or lymph nodes is in
the 80 percent range; at least 25 percent of breast cancer patients
whose disease has metastasized survive five or more years.
to the National Cancer Institute, an estimated 2.5 million women with a
history of breast cancer were alive in 2006 – most of them cancer-free.
The overall five-year survival rate for localized breast cancer is 98
percent, reports the American Cancer Society, while the survival rate
for breast cancer that has spread to the chest wall or lymph nodes is in
the 80 percent range; at least 25 percent of breast cancer patients
whose disease has metastasized survive five or more years.
Despite
improved survival rates, many patients struggle with physical
limitations after treatment – as many as 39 percent, according to the
new findings – yet little attention has been paid to those limitations
and related problems, particularly among older women.
improved survival rates, many patients struggle with physical
limitations after treatment – as many as 39 percent, according to the
new findings – yet little attention has been paid to those limitations
and related problems, particularly among older women.
To
determine how physical limitations following initial breast cancer
treatment affect mortality, the scientists studied 2,202 women in
California and Utah with breast cancer, questioning them about
endurance, strength, muscular range of motion, and small muscle
dexterity following initial treatment such as chemotherapy, radiation
therapy or hormone therapy. The women were part of the Life After Cancer
Epidemiology cohort, and were followed for up to 11 years after
diagnosis.
determine how physical limitations following initial breast cancer
treatment affect mortality, the scientists studied 2,202 women in
California and Utah with breast cancer, questioning them about
endurance, strength, muscular range of motion, and small muscle
dexterity following initial treatment such as chemotherapy, radiation
therapy or hormone therapy. The women were part of the Life After Cancer
Epidemiology cohort, and were followed for up to 11 years after
diagnosis.
Outcomes
differed according to disease stage. Women with localized cancer had
higher rates of non-breast cancer death due to functional limitations
than those with more advanced disease. In addition, women with
functional limitations may have poorer treatment tolerance because they
are more likely to be older, less physically active, and overweight or
obese. As a result, the authors speculate that women with good physical
function who tolerated therapy well might be over-represented in the
group with more advanced disease.
differed according to disease stage. Women with localized cancer had
higher rates of non-breast cancer death due to functional limitations
than those with more advanced disease. In addition, women with
functional limitations may have poorer treatment tolerance because they
are more likely to be older, less physically active, and overweight or
obese. As a result, the authors speculate that women with good physical
function who tolerated therapy well might be over-represented in the
group with more advanced disease.
“There
is increasing evidence that regular physical activity, as little as 30
minutes of moderate intensity walking each day, can reduce the risk of
breast cancer recurrence,’’ said study co-author Patricia Ganz, MD, a
medical oncologist and director of cancer prevention and control at
UCLA’s Jonsson Comprehensive Cancer Center. “Women with functional
limitations are less likely to be able to maintain regular physical
activity and would likely benefit from intervention to reduce their
limitations and increase physical activity.’’
is increasing evidence that regular physical activity, as little as 30
minutes of moderate intensity walking each day, can reduce the risk of
breast cancer recurrence,’’ said study co-author Patricia Ganz, MD, a
medical oncologist and director of cancer prevention and control at
UCLA’s Jonsson Comprehensive Cancer Center. “Women with functional
limitations are less likely to be able to maintain regular physical
activity and would likely benefit from intervention to reduce their
limitations and increase physical activity.’’
Though
the researchers did not specifically study the mechanism, they suggest
that functional limitations may be associated with chronic inflammation,
a key aspect of the immune system’s defenses, which can lead to
diminished function of organs or systems.
the researchers did not specifically study the mechanism, they suggest
that functional limitations may be associated with chronic inflammation,
a key aspect of the immune system’s defenses, which can lead to
diminished function of organs or systems.
In
an accompanying editorial, Harvey Jay Cohen, MD, director of the Center
for the Study of Aging and Human Development at Duke University Medical
Center said the research “enhances our broader understanding of the
issues surrounding functional status assessment and cancer outcomes.’’
an accompanying editorial, Harvey Jay Cohen, MD, director of the Center
for the Study of Aging and Human Development at Duke University Medical
Center said the research “enhances our broader understanding of the
issues surrounding functional status assessment and cancer outcomes.’’
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