Conversations between older people with cancer and their health care providers may lead to increased physical activity that reduces the risk of falling, according to study results presented at the 2024 American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Francisco.

Falls among older individuals can lead to serious problems such as head injury or bone fractures and are a leading cause of non-fatal injuries and death for this population. Physical activity strengthens muscles, improves balance and can reduce the risk of falling.

“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,” lead study author Chuan Lu, MD, MPH, of Dana-Farber Cancer Institute, said in an ASCO news release. “This is especially worrisome for older patients, who often have poorer outcomes following a fall.”

Lu and colleagues analyzed data from more than 100,000 people over age 65 in the Medicare Health Outcome Survey who enrolled in Medicare between 2018 and 2022 and were undergoing cancer treatment at the time of the study. The researchers asked participants about their discussions with health care providers about physical activity and whether they had experienced 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,” Lu said. “However, there is limited understanding of how well this information is communicated to older patients.”

Slightly over half of the participants (57%) recalled starting a conversation with a health care provider about physical activity. A smaller percentage (51%) said their doctors had advised them that increased physical activity could help reduce their risk of falling. These proportions did not change much over time.

Overall, the incidence of falls remained stable, at about 30%, over the course of the study. However, people who recalled having a conversation about physical activity were 21.4% less likely to have experienced a fall, and those who had received advice to increase their physical activity had a 21.6% lower risk.

Further analysis showed that the risk reduction was even greater for patients with lung, colorectal or prostate cancer—groups that are at higher risk for falls. Lung cancer, for example, can impact cardiopulmonary function, which can limit physical activity. Surgery, radiation therapy, chemotherapy and hormone therapy can take a toll on physical function and make it more difficult to exercise due to side effects such as pain, fatigue, muscle weakness, nausea and cognitive problems.

This study did not analyze actual changes in physical activity, but people who started conversations and received advice from their doctors may have been more motivated to increase their activity. The researchers plan to investigate other factors that could contribute to falls and fall-related injuries in older people undergoing cancer treatment.

“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,” said ASCO expert Eleonora Teplinsky, MD, of Valley Health System in New Jersey. “Physical activity has many other benefits as well and should be considered as part of routine oncologic care.”

Click here for more reports from the ASCO Quality Care Symposium.