Jay Harness, Chief Medical Officer at Maple Tree Cancer Alliance, shared on LinkedIn:
“Fitness Is a Vital Sign: Why Functional Assessment Matters for Older and all Adults with Cancer
As cancer survival improves and the population ages, oncology is caring for a rapidly growing number of older adults whose health cannot be understood by looking at their cancer diagnosis alone. Two recent reports in JAMA make an important point that should resonate throughout oncology: physical function, frailty, cognition, and resilience should become part of routine clinical assessment, and they can help guide individualized interventions.
Although these reports focus primarily on older adults and cardiovascular medicine rather than cancer, their implications for Exercise Oncology are substantial.
Physical Fitness Predicts More Than We May Realize.
One report describes a study involving approximately 13,400 adults aged 65 years or older who underwent objective assessments of cardiorespiratory fitness, muscular strength, flexibility, balance, and agility. Participants performed practical tests including chair stands and step tests and were followed for a median of seven years.
The results were striking: higher physical fitness was associated with lower all – cause mortality. Balance and agility showed the strongest associations with lower mortality risk, followed by lower – body strength and cardiorespiratory fitness. The investigators concluded that incorporating fitness assessment into routine geriatric care could improve risk stratification and help clinicians prescribe individualized, function – oriented interventions.
Chronologic age alone tells us relatively little about an individual’s ability to tolerate cancer treatment. Two 75 – year – old patients may have profoundly different levels of strength, mobility, balance, aerobic capacity, independence, and physiologic reserve.
Measuring function gives us information that age alone cannot.
Exercise Oncology programs can provide the infrastructure that oncology practices often lack for systematically assessing and addressing physical function. They can help transform exercise from general lifestyle advice into a measurable component of supportive cancer care.
For older adults with cancer, we should increasingly ask not only: ‘How old is this patient?’ But also:’How fit is this patient, and what can we do to preserve or improve that fitness?’
Cancer centers should consider incorporating baseline and longitudinal functional fitness assessment into the care of older adults with cancer, with referral to qualified Exercise Oncology programs when deficits or risks are identified.
We routinely measure blood pressure, weight, laboratory values, and treatment response. For the growing population of older cancer patients, it is time to give physical function and fitness a similarly prominent place in comprehensive cancer care.
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