Cancer-treatment-induced accelerated aging in older adult cancer survivors: A call for actions for future perspectives in geriatric oncology

Abstract

Cancer treatment has significantly improved survival rates, but older adult cancer survivors remain at risk of cancer-treatment-induced late effects such as cardiac complications and second primary cancers. A new hypothesis emerged in the literature suggesting that such late effects can indeed be the manifestation of an accelerated aging process induced by cancer treatments. The cancer-treatment-induced accelerated aging could first arise from clinical and biological manifestations such as frailty, sarcopenia, cognitive impairments, cellular senescence, telomere attrition, and chronic inflammation, paralleling hallmarks of aging. Older adult cancer survivors frequently demonstrated early-onset frailty, sarcopenia, osteoporosis, cognitive impairments, diminished physical function, and increased levels of aging biomarkers compared to cancer-free age-matched older adults. However, existing studies are limited by their narrow focus on specific cancers, the use of single aging outcome measures, and short follow-up durations. A holistic research approach, incorporating comprehensive geriatric assessments and aging biomarkers, is crucial for describing the induced health burden and the mechanisms underlying these induced aging vulnerabilities. Addressing these gaps through large-scale longitudinal studies could lead to personalized interventions, improved treatment protocols, and supportive care strategies in older adult cancer survivors. Such efforts will enhance quality of life, promote healthy aging trajectories, and mitigate societal and economic burdens. To this end, concrete actions, such as establishing international consortia that include patient advocacy, are encouraged. Efforts should also include developing a centralized, registry-based repository for clinical and biological aging outcomes.

Keywords: Accelerated aging; Cancer treatment optimizations; Cancer treatments; Frailty; Geriatric oncology; Healthy aging; Interventions in older adults; Late effects; Older adults cancer survivors; Sarcopenia; Societal impact; Supportive care.