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Quality of life in elderly with cancer

…and the influence of physical activity and nutrition

  • Personalised treatment has a positive influence on quality of life
  • Attention for both physical and mental well-being increases therapy compliance
  • Nutrition based interventions often neglected for elderly with cancer

When people with cancer follow treatment aimed at physical activity and nutritional status, they perform better physically and have  a higher quality of life. However, this British literature study shows that there are only few studies focusing on elderly with cancer, while this group is getting bigger and bigger. Nevertheless, the researchers conclude that elderly with cancer benefit most from a custom-tailored treatment containing both physical and mental components. Additionally, they advise to do more extensive research into the role of nutritional based treatments in the future.

Nutrition neglected

Even though previous research shows that nutritional status is an important predictor for functional rehabilitation in elderly with cancer, only four out of fourteen studies contained a nutritional component within their treatment protocol. In these four studies, participants mostly received general nutritional advice in accordance with the current nutritional guidelines. However, the researchers advocate for studies including the individual effects of personalised treatments in elderly with cancer, consisting of physical activity, a diet, or a combination of the two. 

Applicability of results

Most participants in this literature study had either breast cancer or prostate cancer, and were sixty years or older. In only two out of fourteen studies, people with a more severe kind of cancer participated, specifically lung and bladder cancer. The researchers therefore emphasise that the results of this literature study cannot be generalised to all elderly with cancer. Future research should focus on the effectiveness of personalised treatments on quality of life of elderly with different types of cancer.

> From: Forbes, J Cancer Surviv 14 (2020) 689-711 . All rights reserved to The Author(s). Click here for the online summary.

Want to read the rest of the article? The free text is available online for free, you can find it here!

Expert opinion by Martijn Stuiver, PhD

The authors of this study remark that, for elderly patients with cancer, the objective of movement interventions (with or without a nutritional component) often comes down to better functioning, and not to better fitness. Therefore, it is no wonder that interventions that took into account not only capacity but also preference the most, resulted in the biggest effects. This result underlines the importance of ‘goal setting’ as part of a methodical approach; stating specific goals and proper communication about these goals is a vital part of the physiotherapeutic treatment of people with cancer in general, and especially for those who are most vulnerable. 

It is striking how little studies were found in which activity and nutrition were combined as a means of intervention, and how common  nutritional interventions were (namely: mainly aimed at education and behaviour, but not including specific individualised dietary restrictions). There is clearly a lot to gain in that area. Accordingly, physiotherapists can learn relatively little from these studies. Nevertheless, based on their common sense and their physiological knowledge, physiotherapists should be alert for problems with nutritional status (both underweight as well as overweight, and especially a deficit in muscle mass masked by overweight), and when in doubt they should consult a dietician. 

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