Exercise and Older Patients With Cancer
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 report lower levels of fatigue, higher levels of functioning, and higher quality of life 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 quality of life arenas (Courneya & Karvinen, 2007). Many older patients receive a diagnosis of cancer in the setting of one or more comorbid conditions, which 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 debilitating when combined with the stressors of cancer and treatment. Age-related pulmonary, cardiac, renal, and gastrointestinal changes 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 resource concerns, and limited social support may further exacerbate suffering in this population.
Although further research is definitely warranted in this 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 quality of life and improving functional status.