Conversations Between Doctors and Older Patients About Physical Activity May Reduce Falls During Cancer Treatment

New Research Will Be Presented at 2024 ASCO Quality Care Symposium

ASCO Perspective Quote

"This study demonstrated a 21% reduction in the risk of falls among patients older than 65 who spoke to their doctors about physical activity. While we do not know how much or what type of activity the patients were doing, this study highlights that counseling about physical activity may reduce fall risk. Physical activity has many other benefits as well and should be considered as part of routine oncologic care." - Eleonora Teplinsky, MD, Medical Oncologist, Valley Health System

Study at-a-Glance

Focus	Fall prevention in older patients with cancer
Population	More than 100,000 people with cancer over the age of 65
Main Takeaway	When health care providers and people with cancer older than 65 have conversations about the importance of physical activity, it may help lower the risk of falls.
Significance	Cancer treatment can often cause side effects, such as muscle weakness, nausea, loss of appetite, cognitive problems, and severe fatigue. These are all negative impacts to a person's physical activity level, nutrition, and overall physical function, which could lead to ultimately higher risk of falling in cancer patients. For people older than 65, this can put them at high risk for falls and fall-related injuries. Falls among people over 65 can lead to serious problems, like a head injury or bone fractures. Recent research has pointed to physical activity as a way to help reduce the risk of falls in people with cancer over the age of 65. Physical activity is known to help strengthen muscles and improve balance. However, it is unclear whether discussions around physical activity as a strategy for lowering the risk of falls regularly happen between health care providers and patients.

ALEXANDRIA, Va. - New research showed that conversations between health providers and older patients with cancer about the importance of physical activity may help lower the risk of falls, which are more common in patients undergoing treatment for cancer. These findings will be presented at the 2024 American Society of Clinical Oncology (ASCO) Quality Care Symposium, taking place September 27-28, 2024, in San Francisco, California.

About the Study

"While falls can happen to anyone at any time, the risk is higher in people with cancer, particularly during the all-consuming period of cancer treatment. This is especially worrisome for older patients, who often have poorer outcomes following a fall. There is increasing awareness among clinicians of the importance of discussing methods to reduce the risk and avoid consequential outcomes from falls, specifically by promoting physical activity to their older patients. However, there is limited understanding of how well this information is communicated to older patients. This study was designed to help reveal the realities of physician-patient interactions about physical activity to prevent falls in real-world clinical settings," said lead study author Chuan Lu, MD, MPH, Dana-Farber Cancer Institute, Boston, Massachusetts.

The researchers looked at data from more than 100,000 people over age 65 who had been enrolled in Medicare between 2018 and 2022. The patients were undergoing cancer treatment at the time.

Key Findings

• The incidence of falls remained steady at about 30% for patients. Slightly over half of the patients recalled starting a conversation with their health care provider about using physical activity as a method for preventing falls (median of 56.8% of patients). A smaller percentage of patients recalled receiving advice from their doctor to increase physical activity in an effort to lower their fall risk (median of 51.4% of patients).
• After further analysis, the researchers found that the patients who did initiate a conversation or received advice from their doctor around physical activity showed a lower risk of falling. Overall, those who proactively started a conversation with their health care provider had a 21.4% lower risk of falling. Those who received advice from their doctor to increase their physical activity had a 21.6% lower risk of falling.
• When looking at data based on specific types of cancer, the study found that people with lung cancer, colorectal cancer, or prostate cancer who had conversations around physical activity showed an even lower risk of falls.
  • The researchers note that this could be explained partly by the typically higher baseline risk of falls in these patients due to the location of the cancer and the standard treatments used.
  • Colorectal and lung cancer, for example, can directly impact cardiopulmonary or digestive functions that are essential to maintain physical activity level, and may lead to an increased risk of falls, as can complications from cancer surgery.
  • For people with prostate cancer, physical function can be affected by radiation therapy or hormone therapy. For these groups of patients, conversations around physical activity may be even more crucial.

Next Steps

The researchers plan to investigate potential barriers and other factors that could contribute to falls and fall-related injuries in older people with cancer undergoing active treatment at the health care system, health care provider, and patient levels.

No funding was received for this study.

View the full abstract

View author disclosures

View the News Planning Team disclosures: https://society.asco.org/sites/new-www.asco.org/files/content-files/about-asco/pdf/2024-QCS-NPT-Disclosures.pdf

ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY QUALITY CARE SYMPOSIUM IS REQUESTED IN ALL COVERAGE.

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Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to the principle that knowledge conquers cancer. Together with the Association for Clinical Oncology, ASCO represents more than 50,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of high quality, equitable patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. Conquer Cancer, the ASCO Foundation, supports ASCO by funding groundbreaking research and education across cancer's full continuum. Learn more at www.ASCO.org, and follow us on Facebook, X, LinkedIn, Instagram, and YouTube.