Breast Cancer Survivors Suffer ‘Greater Loss of Well-Being’ than Noncancer Patients Later in Life

For breast cancer patients, the adverse effects of the cancer and its treatments do not cease when the disease leaves the body, and well-being remains affected. A new study found that older breast cancer survivors live with “a higher level of actionable symptoms and greater loss of well‐being over time” compared to patients without cancer.

According to the authors, they undertook the study because there is little research regarding the long-term symptom burden carried by this population, as well as how this burden affects overall well-being and if lifestyle interventions influence it.

The study focused on breast cancer survivors aged ≥60 years with newly diagnosed, nonmetastatic breast cancer, who were compared to noncancer controls. Recruitment took place between August 2010 and June 2016. The following parameters were used to measure symptom burden: pain (yes or no), fatigue (on the Functional Assessment of Cancer Therapy [FACT]‐Fatigue scale), cognitive problems (on the FACT‐Cognitive scale), sleep problems (yes or no), depression (on the Center for Epidemiologic Studies Depression scale), anxiety (on the State‐Trait Anxiety Inventory), and cardiac problems and neuropathy (yes or no). A 100-point FACT-General scale was used to determine well-being. Lifestyle was assessed by factors including smoking, alcohol use, body mass index, physical activity, and leisure activities. Correlations were analyzed between treatment group (chemotherapy with or without hormone therapy, hormone therapy only, and controls) and symptom burden, lifestyle, and covariates; further analyses assessed how fluctuations in symptom burden and lifestyle affected function.

Symptoms were high at baseline across the whole cohort. The most significant differences between the cancer survivors and controls were observed in cognitive problems, sleep problems, anxiety, and neuropathy. In adjusted analyses, survivors who had undergone chemotherapy had the highest burden score, followed by those who had received hormone therapy, compared to controls (P<0.001). Factors that influenced the burden score were physical, emotional, and mental well-being; survivors with lower burden scores, compared to those with higher burden scores, had 12.4-point higher physical well-being scores. Lifestyle did not affect symptom burden or well-being, although physical activity played a large role in both (P<0.005).

The study was published in the March 15 issue of Cancer.

“Cancer and its treatments are associated with a higher level of actionable symptoms and greater loss of well‐being over time in older breast cancer survivors than in comparable noncancer populations, suggesting the need for surveillance and opportunities for intervention,” summarized the study authors.