Older women with breast cancer experience temporary declines in health-related quality of life

March 28, 2014

A new study finds that women 65 and older who are treated for breast cancer initially experience declines in physical and mental health, compared to similar women without cancer, but the declines generally wane after 12 months. The findings imply that older women should be informed they are more vulnerable to declines in health-related quality of life, but reassured the declines likely are only temporary.

Angela Stover

Angela Stover

In a study published in the March 19 online issue of the journal Cancer, Angela M. Stover, of UNC’s Gillings School of Global Public Health and the UNC Lineberger Comprehensive Cancer Center, along with a team of researchers, examined the effects of breast cancer and its treatments on health-related quality of life for women 65 and older when compared with similar women without cancer.

“Older women historically have been excluded from clinical trials so we know very little about the time it takes them to recover from breast cancer treatment and what the typical declines look like,” Stover said. “This leaves older women with breast cancer in an uncertain position for making an informed decision about treatments to pursue.”

Stover is pursuing her doctorate in health behavior at the Gillings School, and her research is supported by a fellowship from the Cecil G. Sheps Center for Health Services Research.

Physical and mental health, pain, and social functioning had returned to levels similar to women without cancer by about a year after diagnosis. Fatigue generally subsided around 18 months after diagnosis. Older women treated with lumpectomy, lumpectomy and radiation, or mastectomy experienced comparable declines in physical and mental health and recovered at similar rates.

“Similar declines and recovery time occurred across treatment types,” Stover said, “suggesting that older women choosing any one of these treatment types fare equally well in terms of physical and mental health. This should be reassuring to older breast cancer patients who are frequently in good health otherwise with relatively long life expectancies.”

“Cancer-care providers should counsel women 65 years and older diagnosed with breast cancer that survivors within six months of diagnosis are vulnerable to health-related quality of life declines, but only for about a year,” added Hyman Muss, MD, director of geriatric oncology at the Lineberger Comprehensive Cancer Center and co-author of the study.

Data from cancer registries and the Medicare Health Outcomes Survey were used for the study. Questionnaires were completed by older women with and without breast cancer.

Additional study contributors included Deborah K. Mayer, PhD, RN, associate professor in the UNC School of Nursing, and Stephanie B. Wheeler, PhD, assistant professor, and Bryce B. Reeve, PhD, associate professor, of the Gillings School’s health policy and management department. Jessica Lyons now is with Harvard University. All authors were affiliated with the UNC Lineberger Comprehensive Cancer Center at the time of the study.

The article abstract is available online


Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.