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Last Updated: Wednesday, September 22, 2010 | 7:20 PM ET Comments0Recommend0

CBC News

Breast cancer survivors with physical limitations may be at higher risk of dying from causes other than cancer, new U.S. research suggests.

Women who survive breast cancer often have limitations that affect motion, strength and dexterity.

These women had no greater risk of dying from a recurrence of breast cancer than physically fit survivors, but were more likely to die from other causes, according to a study published in Wednesday’s online issue of The Journal of the National Cancer Institute.

In the study, Dejana Braithwaite of the University of California, San Francisco, and colleagues studied 2,202 women with breast cancer who were followed for an average of nine years after diagnosis.

The researchers looked at the impact of functional limitations such as difficulty kneeling, lifting items, reaching for objects, standing or sitting for long periods or walking up to three city blocks.

Age, body mass index, tumour stage and other lifestyle characteristics were taken into account.

The researchers found that 39 per cent of the study participants reported at least one limitation after adjuvant therapy, such as chemotherapy given after initial treatment to increase the chance of long-term survival.

Older and overweight women reported more functional limitations than other women but there was no major impact on survival.

What did affect survival was disease stage. Physical limitation showed a stronger link to survival in women with localized rather than more advanced disease, the researchers found.

This difference may reflect that women with functional limitations have less tolerance for treatment since they tend to be older, less physically active and overweight or obese.

The findings suggest that functional status may be an important factor to consider when identifying groups at high risk of poor prognosis, the researchers said.

“Our observations, combined with those of other investigators, suggest that failure to address physical functioning may have wide-reaching consequences for quality of life and longevity among breast cancer survivors,” the study’s authors concluded.

The researchers acknowledged limitations of the study, including:

• A lack of assessment of physical functioning before breast cancer diagnosis.
• Few details on how the functional impairments could affect mortality such as from cardiovascular disease or diabetes.
• The absence of a control group of women without breast cancer to tell whether the mortality increase from functional limitations was higher among women with breast cancer.

Nevertheless, followup was excellent and important information emerged from the study, said Dr. Harvey Jay Cohen of the Duke Center for the Study of Aging and Human Development in Durham, N.C.

In a journal editorial accompanying the study, Cohen said the new findings suggest that disease screening, chronic disease management and diet can exercise programs for cancer survivors “can have a substantial impact” and should be followed.