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Old Age After Breast Cancer

Posted 2/4/2014

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  Living into old age is the prize. Now, I realize and completely agree that there are some caveats and limits on this statement. None of us want to end up demented in a nursing home. Most of us don't want to long outlive all the people whom we love. But, as long as we are pretty healthy and loved and occupied, most of us hope to stay around.

  Worrying about long term or very long term consequences of breast cancer did not used to be an issue. Since there are now many more women living out long lives after cancer, the possible problems related to surgery or medical treatment may become bigger problems. This is different than the concerns for elderly women who are initially diagnosed. For them, the questions about how to safely and effectively and wisely treat breast cancer are related to risk vs. benefit ratios. For example, many old women have a lumpectomy without radiation because it could be very difficult for them to come to radiation treatment daily for six weeks and because we know that they are likely not to live to or past the time when the higher risk of a local recurrence could be a problem.

 This study from the UK is about women who were diagnosed and treated as younger women and who have lived into old age. Some suffer from chronic pain, limitations from surgery, cardiac issues from treatment, etc. Here is the abstract from the European Journal of Oncology Nursing.I am unable to include a workable link, so email me if you want the whole article, and I am happy to send it (hhill@bidmc.harvard.edu)


Living into old age with the consequences of breast cancer
Deborah Fenlon a,*, Jane Frankland a, Claire L. Foster a, Cindy Brooks a, Peter Coleman a, Sheila Payne b,
Jane Seymour c, Peter Simmonds a, Richard Stephens d, Bronagh Walsh a, Julia M. Addington-Hall 

a b s t r a c t
Purpose of the research: Breast cancer survival rates are improving with over 60% likely to live 20 years. As
30% diagnoses occur in women over 70 the prevalence of breast cancer survivors living into older age is
increasing. The specific needs and experiences of this group have rarely been addressed. This study
aimed to explore older women’s experience of living with breast cancer alongside other health conditions,
and to identify their information and support needs and preferences.
Methods and sample: Data were collected from 28 semi-structured qualitative interviews and 2 focus
groups (n ¼ 14), with breast cancer survivors aged 70e90, and were analysed using thematic analysis.
Key results: These older breast cancer survivors experienced a range of long-term physical problems
resulting from treatment, including poor cosmetic results and poor shoulder movements, and bras and
prostheses were often unsuitable. Many were keen to preserve their body image ideal irrespective of age.
Reconstruction was rarely discussed, but all would have liked this option. Older women wanted to be
treated as individuals rather than uniformly as older people, with their personal physical and social
needs (including co-morbidities) taken into account. They expressed a preference for information direct
from health professionals.
Conclusions: Many breast cancer survivors will live into advanced old age with permanent physical and
emotional consequences of their treatment. Holistic and personalized assessment of needs becomes
increasingly important with age, particularly with comorbidity. Effective rehabilitative care is important
to reduce the impact of breast cancer into old age.

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