Older patients with cancer remain relatively underrepresented in clinical trials in general, let alone in trials examining exercise and its effects. However, a review of the literature did support that older patients who have higher levels of physical activity during their cancer treatment reported lower levels of fatigue, higher levels of functioning, and higher quality-of-life (QOL) evaluations both during and after their treatment. Additional findings, however, suggest that increased age correlated negatively with adherence (Courneya, Vallance, McNeely, Karvinen, Peddle, & Mackey, 2004; Luctkar-Flude, Groll, Tranmer, & Woodend, 2007).
Studies have demonstrated that older patients with cancer tend to suffer less psychological distress when compared to younger patients, but suffer more intently in other QOL arenas (Courneya & Karvinen, 2007). Many older patients receive their cancer diagnosis along with one or more comorbid conditions that, when combined with cancer-treatment side effects, can drastically affect functional capacity. Older patients are often contending with natural age-related effects as well, such as failing hearing or vision and decreased mobility, which may prove to be debilitating when combined with the stressors of cancer and treatment. Age-related pulmonary, cardiac, renal, and gastrointestinal changes also have been shown to exacerbate treatment-related toxicities (Courneya & Karvinen, 2007). These compounded stressors may enhance, accelerate, or initiate symptoms of depression, anxiety, or delirium. Social issues such as living alone, financial concerns, and limited social support may further exacerbate suffering in this population.
Although further research is definitely warranted in the older adult population, these findings suggest that it is crucial to strategize with older patients to promote adherence in all ways possible. Given the expected functional decline in older people, outcomes may be best focused on enhancing QOL and improving functional status.
Courneya, K.S., & Karvinen, K.H. (2007). Exercise, aging, and cancer. Applied Physiology, Nutrition, and Metabolism, 32, 1001-1007. doi: 10.1139/H07-074
Courneya, K.S., Vallance, J.K., McNeely, M.L., Karvinen, K.H., Peddle, C.J., & Mackey, J.R. (2004). Exercise issues in older cancer survivors. Critical Reviews in Oncology and Hematology, 51, 249–261. doi: 10.1016/j.critrevonc.2004.05.001
Luctkar-Flude, M.F., Groll, D.L., Tranmer, J.E., & Woodend, K. (2007). Fatigue and physical activity in older adults with cancer. Cancer Nursing, 30, E35–E45. doi: 10.1097/01.NCC.0000290815.99323.75