Frailty and Aging in Cancer Survivors

Overview

Journal Transl Res

Publisher Elsevier

Specialty Pathology

Date 2020 May 4

PMID 32360946

Citations 47

Authors

Kirsten K Ness

Matthew D Wogksch

Affiliations

Soon will be listed here.

Abstract

There are over 15 million survivors of cancer in the United States whose rates of frailty, an aging phenotype, range from just under 10% to over 80%. Frailty impacts not only disease survival but also long-term function and quality of life in children, adolescents, and in all adults diagnosed and/or treated for cancer. This review explains frailty as a construct and model of physiologic well-being. It also describes how frailty at diagnosis impacts cancer outcomes in adult populations and enumerates the prevalence of frailty in different populations of cancer survivors. Biological mechanisms responsible for aging and potentially for frailty among individuals with or who have been treated for cancer are discussed. Finally, promising pharmaceutical and lifestyle interventions designed to impact aging rather than a specific disease, tested in other populations, but likely applicable in cancer patients and survivors, are discussed.

Citing Articles

Metabolic reprogramming in cancer and senescence.

Zhang Y, Tang J, Jiang C, Yi H, Guang S, Yin G MedComm (2020). 2025; 6(3):e70055.

PMID: 40046406 PMC: 11879902. DOI: 10.1002/mco2.70055.

Calcium (Ca) fluxes at mitochondria-ER contact sites (MERCS) are a new target of senolysis in therapy-induced senescence (TIS).

Puebla-Huerta A, Huerta H, Quezada-Gutierez C, Morgado-Caceres P, Casanova-Canelo C, Nino S NPJ Aging. 2025; 11(1):11.

PMID: 39984524 PMC: 11845618. DOI: 10.1038/s41514-025-00197-1.

Frailty: Can a Biological Aging Marker Enhance Precision Risk Assessment of Cancer Therapy Cardiotoxicity?.

Sedrak M, Asnani A JACC CardioOncol. 2025; 7(2):122-124.

PMID: 39967197 PMC: 11866427. DOI: 10.1016/j.jaccao.2025.01.004.

A meta-analysis on the impact of concurrent or pre-existing cancer diagnosis on acute myocardial infarction outcomes.

Wang J, Yu J PLoS One. 2025; 20(1):e0318437.

PMID: 39888923 PMC: 11785289. DOI: 10.1371/journal.pone.0318437.

Pain and Frailty in Childhood Cancer Survivors: A Narrative Review.

Papini C, Sodhi J, Argenbright C, Ness K, Brinkman T Curr Oncol. 2025; 32(1).

PMID: 39851938 PMC: 11763768. DOI: 10.3390/curroncol32010022.

References

Boldrin E, Rumiato E, Fassan M, Rugge M, Cagol M, Marino D . Genetic risk of subsequent esophageal cancer in lymphoma and breast cancer long-term survival patients: a pilot study. Pharmacogenomics J. 2015; 16(3):266-71. DOI: 10.1038/tpj.2015.41. View

Franco I, Chen Y, Chipidza F, Agrawal V, Romano J, Baldini E . Use of frailty to predict survival in elderly patients with early stage non-small-cell lung cancer treated with stereotactic body radiation therapy. J Geriatr Oncol. 2017; 9(2):130-137. DOI: 10.1016/j.jgo.2017.09.002. View

Bennett J, Winters-Stone K, Dobek J, Nail L . Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum. 2013; 40(3):E126-34. PMC: 3988495. DOI: 10.1188/13.ONF.E126-E134. View

Kober K, Mazor M, Abrams G, Olshen A, Conley Y, Hammer M . Phenotypic Characterization of Paclitaxel-Induced Peripheral Neuropathy in Cancer Survivors. J Pain Symptom Manage. 2018; 56(6):908-919.e3. PMC: 6289693. DOI: 10.1016/j.jpainsymman.2018.08.017. View

Hildebrandt M, Reyes M, Wu X, Pu X, Thompson K, Ma J . Hypertension Susceptibility Loci are Associated with Anthracycline-related Cardiotoxicity in Long-term Childhood Cancer Survivors. Sci Rep. 2017; 7(1):9698. PMC: 5575079. DOI: 10.1038/s41598-017-09517-2. View

Collard R, Boter H, Schoevers R, Oude Voshaar R . Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012; 60(8):1487-92. DOI: 10.1111/j.1532-5415.2012.04054.x. View

MKacher R, Girinsky T, Koscielny S, Dossou J, Violot D, Beron-Gaillard N . Baseline and treatment-induced chromosomal abnormalities in peripheral blood lymphocytes of Hodgkin's lymphoma patients. Int J Radiat Oncol Biol Phys. 2003; 57(2):321-6. DOI: 10.1016/s0360-3016(03)00578-9. View

Collins B, Laakkonen E, Lowe D . Aging of the musculoskeletal system: How the loss of estrogen impacts muscle strength. Bone. 2019; 123:137-144. PMC: 6491229. DOI: 10.1016/j.bone.2019.03.033. View

Coughlin S, Smith S . The Insulin-like Growth Factor Axis, Adipokines, Physical Activity, and Obesity in Relation to Breast Cancer Incidence and Recurrence. Cancer Clin Oncol. 2015; 4(2):24-31. PMC: 4524449. DOI: 10.5539/cco.v4n2p24. View

10.

Harrigan M, Cartmel B, Loftfield E, Sanft T, Chagpar A, Zhou Y . Randomized Trial Comparing Telephone Versus In-Person Weight Loss Counseling on Body Composition and Circulating Biomarkers in Women Treated for Breast Cancer: The Lifestyle, Exercise, and Nutrition (LEAN) Study. J Clin Oncol. 2015; 34(7):669-76. PMC: 4872022. DOI: 10.1200/JCO.2015.61.6375. View

11.

Ariffin H, Azanan M, Abd Ghafar S, Oh L, Lau K, Thirunavakarasu T . Young adult survivors of childhood acute lymphoblastic leukemia show evidence of chronic inflammation and cellular aging. Cancer. 2017; 123(21):4207-4214. DOI: 10.1002/cncr.30857. View

12.

Saxton J, Scott E, Daley A, Woodroofe M, Mutrie N, Crank H . Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial. Breast Cancer Res. 2014; 16(2):R39. PMC: 4052984. DOI: 10.1186/bcr3643. View

13.

Smitherman A, Anderson C, Lund J, Bensen J, Rosenstein D, Nichols H . Frailty and Comorbidities Among Survivors of Adolescent and Young Adult Cancer: A Cross-Sectional Examination of a Hospital-Based Survivorship Cohort. J Adolesc Young Adult Oncol. 2018; 7(3):374-383. PMC: 5994155. DOI: 10.1089/jayao.2017.0103. View

14.

Walter K, Ford M, Gregoski M, Kramer R, Knight K, Spruill L . Advanced glycation end products are elevated in estrogen receptor-positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention. Breast Cancer Res Treat. 2018; 173(3):559-571. PMC: 6394600. DOI: 10.1007/s10549-018-4992-7. View

15.

McCubrey J, Lertpiriyapong K, Steelman L, Abrams S, Yang L, Murata R . Effects of resveratrol, curcumin, berberine and other nutraceuticals on aging, cancer development, cancer stem cells and microRNAs. Aging (Albany NY). 2017; 9(6):1477-1536. PMC: 5509453. DOI: 10.18632/aging.101250. View

16.

Greenlee H, Gaffney A, Aycinena A, Koch P, Contento I, Karmally W . Long-term Diet and Biomarker Changes after a Short-term Intervention among Hispanic Breast Cancer Survivors: The ¡Cocinar Para Su Salud! Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev. 2016; 25(11):1491-1502. PMC: 5501703. DOI: 10.1158/1055-9965.EPI-15-1334. View

17.

Klein B, Klein R, Knudtson M, Lee K . Frailty, morbidity and survival. Arch Gerontol Geriatr. 2005; 41(2):141-9. DOI: 10.1016/j.archger.2005.01.002. View

18.

Maccormick R . Possible acceleration of aging by adjuvant chemotherapy: a cause of early onset frailty?. Med Hypotheses. 2006; 67(2):212-5. DOI: 10.1016/j.mehy.2006.01.045. View

19.

Galasko D, Bell J, Mancuso J, Kupiec J, Sabbagh M, Van Dyck C . Clinical trial of an inhibitor of RAGE-Aβ interactions in Alzheimer disease. Neurology. 2014; 82(17):1536-42. PMC: 4011464. DOI: 10.1212/WNL.0000000000000364. View

20.

Guy Jr G, Yabroff K, Ekwueme D, Rim S, Li R, Richardson L . Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States. J Clin Oncol. 2017; 35(18):2053-2061. PMC: 6059377. DOI: 10.1200/JCO.2016.71.9716. View