Falls lead to worse outcomes in cancer survivors primarily because cancer and its treatments often cause physical and neurological impairments that increase vulnerability to injury and complicate recovery. These impairments include muscle weakness, balance problems, nerve damage, bone fragility, and fatigue, all of which raise the risk of falling and make falls more dangerous for this population.
Cancer treatments such as chemotherapy, radiation, and surgery can cause peripheral neuropathy, which is nerve damage leading to numbness, tingling, and loss of sensation in the hands and feet. This neuropathy impairs balance and coordination, making it harder for survivors to detect hazards or adjust their posture to prevent falls. When falls occur, the lack of protective reflexes and diminished sensation can result in more severe injuries. Additionally, chemotherapy and radiation can weaken bones, especially if cancer has spread to the skeleton, increasing the risk of fractures from even minor falls.
Muscle loss, known as sarcopenia, is common in cancer survivors due to the disease itself, treatment side effects, and reduced physical activity. This loss of muscle mass and strength reduces functional capacity and stability, making it more difficult to maintain balance or recover from a stumble. Fatigue, another common side effect, further limits physical activity and alertness, increasing fall risk.
Moreover, cancer survivors often have comorbidities and age-related declines that compound these risks. Older survivors may already face frailty, reduced mobility, and chronic conditions such as arthritis or cardiovascular disease, which impair balance and recovery. When combined with cancer-related impairments, these factors create a perfect storm for falls and poor outcomes.
Falls in cancer survivors are not only more frequent but also more consequential. Injuries such as fractures, head trauma, or soft tissue damage can lead to prolonged hospitalizations, delayed cancer treatments, and reduced independence. For example, a hip fracture can severely limit mobility and increase the risk of complications like infections or blood clots. These setbacks can worsen overall prognosis and quality of life.
Psychologically, fear of falling can lead to activity avoidance, which further accelerates physical decline and social isolation. This vicious cycle increases frailty and the likelihood of future falls. Additionally, some survivors may live far from rehabilitation centers or gyms, limiting access to balance training or physical therapy that could reduce fall risk.
Exercise and physical activity tailored to the survivor’s condition can help mitigate these risks by improving muscle strength, balance, and coordination. However, exercise programs must be carefully designed to avoid high-impact activities in those with bone metastases or severe neuropathy. Safer options include swimming, cycling, resistance training with bands, and supported balance exercises. Monitoring heart health and fatigue levels is also essential during exercise.
In summary, falls lead to worse outcomes in cancer survivors because the combined effects of cancer, its treatments, and aging create physical vulnerabilities that increase fall risk and injury severity. These injuries disrupt cancer care, reduce functional independence, and worsen overall health, making fall prevention and tailored rehabilitation critical components of survivorship care.