Research Reveals Ways to Improve Daily Physical Function for Cancer Survivors.

Our research, published in the Journal of Cancer Survivorship, helps us understand the risk of functional limitations after cancer treatment, enabling us to improve care for survivors.

There are many ways cancer survivors acknowledge the completion of treatment. For some, ringing the bell represents a meaningful milestone and moment of celebration. Others may choose to celebrate by returning to activities, routines, or moments with loved ones that were put on hold during treatment. While treatment ending is often a significant step forward, many survivors continue to navigate ongoing physical, emotional, and everyday challenges afterward.

Our research, published in the Journal of Cancer Survivorship, examined how cancer survivors function in daily life years after treatment. After treatment, activities that used to be automatic, such as walking to the mailbox or having dinner with friends, may require more effort or cause discomfort.

Cancer survivors sometimes do not realize that these functional limitations are a documented side effect of the cancer journey. They may consider the new difficulties a tradeoff because they are grateful to be cancer-free. However, care for functional challenges after cancer treatment is available, and it can help survivors improve their quality of life through efforts such as the MedStar Health Cancer Survivorship Program.

Our study helps get a sense of how likely someone is to experience functional limitations after cancer treatment. We took a deep dive to explore how having a history of cancer increases the risk of physical limitations and how that risk changes with age.

Analyzing cancer’s impact on physical function.

To get a clear picture of the survivor experience across the country, we analyzed data from the National Health Interview Survey collected between 2014 and 2018, from more than 150,000 adults. We compared the physical health of 12,518 cancer survivors against 138,991 people who had never been diagnosed with cancer. 

We focused on functional limitations—physical difficulties that hinder a person’s ability to move through the world and perform daily tasks. Specifically, we assessed nine physical activities associated with mobility and strength:
​

• Walking a quarter of a mile

• Climbing 10 steps without resting

• Standing for two hours

• Sitting for two hours

• Stooping, bending, or kneeling

• Reaching over the head

• Using fingers to grasp small objects

• Lifting or carrying 10 pounds

• Participating in social activities

After statistical analysis, our findings revealed that the physical impact of cancer is high, especially for younger survivors. 

Related: Read “Study Incorporates Patient Experience to Design Virtual Reality Tool for Cancer Pain Management.”

Study results: A chance to support survivors.

The results of our study confirmed what many cancer survivors experience: having a history of cancer significantly increases the odds of having a functional limitation.

One of the most striking aspects of our research concerns younger people. We found that cancer survivors between the ages of 18 and 44 were nearly three times as likely to have functional limitations as people in the same age group who never had cancer. This suggests a process called accelerated aging, in which cancer and its treatments can cause a survivor’s body to function as if it were older than it is.

While you might expect someone in their 70s to have difficulty with mobility, seeing this level of functional limitation in younger people is a signal that cancer and its treatments can have a profound impact on health outcomes after treatment completion.

Our study found that cancer survivors had the most challenges with mobility and lower-body tasks, such as standing or walking. The 18-44 age group also reported difficulty sitting for two hours, which can be a barrier to daily life in many ways, from working at a desk to enjoying a movie with friends.

Related: Read “Research: At-home Therapy via Smart Speaker Can Help Cancer Survivors Solve Insomnia.”

Putting data into action for patients.

Functional changes and limitations after cancer treatment are common, but there are programs that can help. With robust support such as physical therapy or specialized rehabilitation, we can improve cancer survivorship. Gathering data is a critical part of understanding how to improve patient care, and this study helps us better identify a care gap that can challenge cancer survivors. 

While oncologists focus on reducing the risk of recurrence, screening for functional limitations can take a back seat. Our research underlines the importance of making conversations about physical function a standard part of follow-up care. 

Next steps: The future of survivorship screening.

Building on this research, our team is now leading a six-year UG3/UH3 study funded by the National Institutes of Health to deliver an evidence-based intervention to older cancer survivors to reduce treatment toxicity and improve quality of life. This work focuses on three main goals:
​

• Real-time assessment: Asking patients to complete forms on things like falls, social support, and functional supports prior to starting treatment to make sure to provide necessary referrals or adjust treatments

• Provider training: We’re teaching clinical teams how to deliver and interpret these results, so these issues are taken into consideration and treatment planning

• Closing the referral loop: We’re tracking how these screenings lead to referrals for physical therapy or other services, or treatment modifications, to help older adults better tolerate treatment and lower the risk of complications during treatment.

Advocating for recovery.

Our research shows that the impact of cancer lasts long after treatment ends. It also reveals an opportunity to change the experience of aging for cancer survivors, ensuring they have support to thrive, not just survive, after treatment.

If you’re having trouble standing at your job or walking as far as you used to, bring these challenges up with your care team. After identifying these limitations, they can connect you with supportive care.

Surviving cancer doesn’t mean you must live with limits. Talk with a doctor about ways to optimize your daily function in this new chapter of life.