Frailty in Cancer Patients, Young and Old, is Linked to Inflammation

Mar. 11, 2021
Two female scientists, Nikesha Gilmore and Michelle Janelsins, in a research laboratory
Nikesha Gilmore, PhD, left, and Michelle Janelsins, PhD, in their research laboratory

Did you know that “frailty” is a medical condition? Characterized by weakness, fatigue, weight loss, and slow walking speed, it’s associated with cancer and its treatments. Scientists are studying the factors that lead to frailty and how to prevent it — because it can impact quality of life and how a person of any age endures disease. 

For women with breast cancer, frailty is linked to inflammation levels in the blood, according to a Wilmot Cancer Institute investigation. Higher inflammation prior to chemo therapy can predict frailty after chemotherapy ends.

“Our findings confirm that oncologists should consider inflammation and frailty in their patients, and perhaps personalize treatment, especially in older adults, to avoid undue risks of chemotherapy toxicity,” said Nikesha Gilmore, Ph.D., research assistant professor of Surgery at the University of Rochester Medical Center, who conducts studies for Wilmot’s Cancer Prevention and Control program.

Gilmore is first author of the study, recently published in the journal, Breast Cancer Research, which includes a novel finding that when inflammation markers continue to rise during chemotherapy, frailty is even more likely to be a problem after treatment.

The study was a secondary analysis of a national cohort of 581 women with breast cancer (stages 1 to 3C). Researchers looked at blood samples pre- and post-treatment, to check for imbalances in white blood cells and inflammatory markers. Six months after completing chemotherapy, 161 of the women had not returned to their pre-chemo inflammation levels.

Future research should focus on whether it’s possible to reduce inflammation before treatment begins, to lessen the burden of frailty, Gilmore said.

The mean age of the women in the study was 53, suggesting that frailty can occur among younger patients, too, the authors noted.

Another interesting observation, she said, was that women who were married or in a long-term relationship appeared to be more protected from frailty. This is in line with other studies suggesting that cancer patients with spouses or significant partners tend to live longer. Gilmore and others have speculated that it may be due to better social support.

Corresponding author of the study is Michelle Janelsins, Ph.D., who is Gilmore’s mentor, an associate professor of Surgery at URMC, and a Wilmot investigator. Her special interest is cognitive difficulties in people with cancer and how best to treat and prevent the condition, which is also known as “chemo brain.”

Funding was provided by the University of Rochester Clinical and Translational Science Institute, the Wilmot Cancer Research Fellowship, the National Cancer Institute, and the National Institute on Aging.