Physical, emotional burden of breast cancer lingers for older survivors

Apr 7 2007

Surviving breast cancer is both a physical and an emotional ordeal, but the consensus among researchers is that life generally returns to normal for most women within two years of completing treatment.

And while that time frame may hold true for younger women, a new study led by a researcher at the University of Georgia College of Public Health finds that women over age 70 fare much worse.

Even five years after completing treatment, older breast cancer survivors consistently score lower in measures of well-being such as life satisfaction when compared to a control group of women matched for age and socioeconomic status. The study, published in the April issue of the journal Critical Reviews in Oncology/Hematology, also found that survivors have more health problems and lower psychological and social well-being than women who were never diagnosed.

"When we began this study, we thought we might see the survivors faring worse in certain domains," said lead author Claire Robb, assistant professor of epidemiology, "but what was surprising was that in nearly each and every measure we looked at, the survivors showed decrements."

Robb and her colleagues surveyed 127 older breast cancer survivors on a host of physical and emotional variables and compared their results with a control group of 87 women who had never been diagnosed with breast cancer. The survivors had been free of cancer for an average of five years and their average age was 78.

Using a widely recognized measure of quality of life, the study showed survivors reporting consistently worse outcomes in both physical and mental health. The researchers observed decrements in areas such as physical functioning, pain, vitality and emotional well-being. Survivors also reported a significantly greater number of days when fatigue interfered with their daily activities. And while there was no difference in presence of depressive symptoms between groups, the survivors reported significantly less life satisfaction.

"If a woman gets breast cancer at 70 and is successfully treated, she could easily have 15 years of life ahead of her," Robb said. "What we're trying to do is find ways to improve the quality of those years. Older adults have the right to feel good and to enjoy life."

Of course, there's a great deal of individual variability in how women fare after surviving breast cancer. In a related article, by Elizabeth Perkins at the University of South Florida in Tampa and co-authored by Robb, the researchers examined factors that play a role in individual differences in well-being among survivors.

The article, published in the same journal and using the same sample of women, shows that factors such as optimism, a sense of control over one's life, spirituality and social support were associated with a higher overall sense of well-being.

Robb said that research into quality of life in older cancer survivors is still in its infancy, so it's unclear what interventions will be most effective at boosting protective factors and improving quality of life.

"First we have to recognize the risk factors and from there we can start to work on improving quality of life for survivors," she said. "Right now, we need to make people aware that this problem exists. Our population is rapidly aging and cancer is a disease of aging. This problem is not going to go away."