Article

The impact of cancer and its treatments on balance and
functional mobility in older adults remains unknown but is increasingly
important, given the evolution of cancer treatments. Subacute and more persistent
side effects such as chemotherapy-induced peripheral neuropathy are on the rise,
and the effects on mobility and balance, as well as the prognosis for resolution
of any functional deficits, must be established before interventions can be
trialed. The purpose of this case report is to describe the severity and
long-term persistence of mobility decline in an older adult who received
neurotoxic chemotherapy. To our knowledge, this is the first case report to
describe an older adult with chemotherapy-induced peripheral neuropathy using
results of standardized balance and mobility tests and to focus on prognosis by
repeating these measures more than 2 years after chemotherapy. CASE DESCRIPTION:
An 81-year-old woman received a neurotoxic agent (paclitaxel) after curative
mastectomy for breast cancer. Baseline testing prior to taxane therapy revealed a
socially active woman with no reported functional deficits or neuropathic
symptoms, 1.2-m/s gait speed, and performance at the ceiling on balance and gait
portions of a standardized mobility measure. OUTCOMES: After 3 cycles, paclitaxel
therapy was stopped by the oncologist because of neurotoxicity. Declines as large
as 50% were seen in performance-based measures at 12 weeks and persisted at 2.5
years, and the patient reported recurrent falls, cane use, and mobility-related
disability. DISCUSSION: This case highlights the extent to which function can
decline in an older individual receiving neurotoxic chemotherapy, the potential
for these deficits to persist years after treatment is stopped, and the need for
physical therapy intervention and further research in this population.

Langue : ANGLAIS