Functional disability in newly diagnosed breast cancer is greater in older African Americans

Many older women with newly diagnosed breast cancer have difficulty accomplishing daily tasks, and African Americans seem to be disproportionately affected. These findings suggest that many breast cancer patients could benefit from receiving therapy to improve their physical function.

Many studies conducted in older adults have demonstrated that, compared with whites, African Americans are more likely to experience functional disability, or the need for assistance with activities of daily living such as bathing, dressing, toileting, feeding, shopping, preparing meals, using the telephone, housekeeping, and managing medications and finances. However, none of these studies had been conducted in older cancer patients or in cancer survivors.

Cynthia Owusu, MD, MS, of the Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland, Ohio, and her colleagues looked to see if there are racial differences in functional disability among older women with newly diagnosed breast cancer. The researchers enrolled 190 women age 65 years or older at the time of diagnosis, and they found that 39% of them experienced functional disability. The study was published in Cancer (2013; doi:10.1002/cncr.28232).

African American women were four times as likely to have functional disability compared with non-Hispanic white women. This racial difference in functional status disappeared when the researchers took into account African American participants' lower household income and educational status and their higher prevalence of chronic medical conditions.

"These findings have implications for cancer treatment decision-making since optimum functional status is a key factor considered in treatment selection. At-risk groups for functional disability, such as older African Americans, may be less likely to tolerate standard treatment and therefore interventions ought to be developed to improve their physical function," said Owusu. "Moreover, such [persons] may be more likely to experience persistent functional decline after treatment, further worsening their survival outcomes."

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