Breast cancer treatment and its effects on aging

J Geriatr Oncol. 2019 Mar;10(2):346-355. doi: 10.1016/j.jgo.2018.07.010. Epub 2018 Aug 2.

Abstract

Breast cancer is the most common cancer of women in the United States. It is also proving to be one of the most treatable. Early detection, surgical intervention, therapeutic radiation, cytotoxic chemotherapies and molecularly targeted agents are transforming the lives of patients with breast cancer, markedly improving their survival. Although current breast cancer treatments are largely successful in producing cancer remission and extending lifespan, there is concern that these treatments may have long lasting detrimental effects on cancer survivors, in part, through their impact on non-tumor cells. Presently, the impact of breast cancer treatment on normal cells, its impact on cellular function and its effect on the overall function of the individual are incompletely understood. In particular, it is unclear whether breast cancer and/or its treatments are associated with an accelerated aging phenotype. In this review, we consider breast cancer survivorship from the perspective of accelerated aging, and discuss the evidence suggesting that women treated for breast cancer may suffer from an increased rate of physical and cognitive decline that likely corresponds with underlying vulnerabilities of genome instability, epigenetic changes, and cellular senescence.

Keywords: Aging; Breast cancer; Cognitive decline; Epigenetic clock; Physiological decline; Senescence; Telomere length; Tissue age; p16(INKa).

Publication types

  • Review

MeSH terms

  • Aging*
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Cancer Survivors
  • Cardiorespiratory Fitness*
  • Cellular Senescence*
  • Cognitive Dysfunction*
  • Epigenesis, Genetic*
  • Female
  • Genomic Instability
  • Humans
  • Menopause, Premature*
  • Survivorship

Substances

  • Antineoplastic Agents