Physical limitations take a significant toll in breast cancer survivors

Basic physical limitations following breast cancer treatment can have far-reaching consequences that substantially affect how long a patient lives.

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.

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.

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.

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.

“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.’’

Braithwaite 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.’’

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.