Women who survive cancer are more likely to experience fatigue and depression related to cancer than men, according to a new investigation presented on Tuesday at the annual meeting of the American Cancer Research Association in Chicago.
As a result, women are less likely to participate in recreational physical activity, which over time exacerbates their symptoms and reduces their quality of life, suggests research.
The new findings are based on previous investigations that found that women develop more serious side effects during cancer treatment than men. They also underline the “very real consequences” that cancer treatment can have for women after having entered the remission, said Joseph Unger, a bioestatic and cancer researcher with the Fred Hutch Cancer Center in Seattle that did not participate in the study.
“Cancer treatments are increasingly effective in keeping patients alive and converting cancer into chronic disease,” said Unger, who studies the quality of life of cancer patients. “It is understandable that patients do not want to live, they want to live well. So, that is where this research helps us to point to us in the following direction.”
Dr. Simo Du, principal author of the resident doctor of study and internal medicine of NYC Health + Hospitals/Jacobi, had noticed that many more female cancer survivors than male in their clinic complained of fatigue that made it difficult to buy groceries, dress, shower and do other social activities or related to hygiene.
To better understand how this disparity affected the quality of life of the patients, DU and their colleagues analyzed the responses of 1,555 adult cancer survivors that were included in the 2015-2016 and 2017-2020 cohorts of the National Survey of Health and Nutrition Examination.
The participants answered questions about whether they feel desperate, deal with a bad appetite, experience sleeping problems and have self -harm thoughts. They also completed questionnaires about the type of physical activities in which they participate.
In general, the researchers said, the responses could be extrapolated to 25 million survivors with more than 20 different types of cancer in the United States, including those of the prostate, the breast, the skin, the colon and the cervix.
The findings have not yet been published in a magazine reviewed by pairs.
Why women have a worse quality of life after cancer
The study found that, compared to male survivors, cancer survivors had 69% more likely to inform cancer -related fatigue and 58% more likely to report depression.
While fatigue is already known that it affects more than 80% of people with cancer, the study found that women had 1.5 times more likely than men to experience it.
Cancer treatments affect the entire body, since they can kill cancer and healthy cells, said Carolyn Gotay, an emergency researcher and professor of public population and public health at the University of British Columbia in Vancouver who did not participate in the study. These effects can persist for months or years after the treatment is performed, he said, leaving survivors with a series of health problems, from deafness to infertility.
Fatigue and depression related to cancer can be caused by cancer itself or the other medical conditions it causes, according to the National Cancer Institute. The emotional impact of dealing with the disease can also cause these symptoms.
Why women have the worst part of these effects still without being clear, although experts have some theories.
Research shows that women have stronger immune responses to treatments, which causes greater inflammation. Women also tend to eliminate drugs from their bodies more slowly than men, Du said, which leads to higher concentrations of medications in their system and, therefore, worse symptoms. It is also possible that differences in body size affect how drugs and radiation are distributed and absorbed in women’s bodies.
It is also more likely that women develop cancers that are treated with hormonal therapies that can greatly contribute to fatigue and depression, Du said. Some of these therapies, such as the tamoxifen used to treat some breast cancers, are taken for five to 10 years after the remission to reduce the possibilities of cancer returning, according to the American cancer society.
That said, women are more likely to denounce fatigue and depression even without a diagnosis of cancer, Gotay said, so it is possible that sex -related hormonal differences best explain why women experience more of these symptoms from the beginning.
Du said that social norms may also play a role. Women generally have more caregivers, such as serving children and tasks that can increase stress and contribute to fatigue and depression, he said.
In particular, the study found that men were more likely to have thoughts “that would be better dead,” Du said. This finding reflects other data that show that suicide rates are generally higher in men than in women. Du speculated that social norms, namely, the expectations that men should be able to provide their families, could be the fault.
How can exercise help
The study also found that, among all cancer survivors, those who did moderate physical activity, such as walking or cycling, had a 50% lower risk of fatigue related to cancer. Those who participated in a more vigorous activity did not see any improvement in their energy, said Du.
Meanwhile, moderate and vigorous activity was associated with a decrease of two to five times in the risk of depression, according to the investigation.
In general, the results suggest that after cancer therapy programs should prioritize exercise. A 2024 review of 113 random controlled trials reached similar conclusions and discovered that exercise, together with cognitive behavioral therapy and programs based on full attention, improved fatigue related to cancer during cancer treatment during and after cancer.
“We always prescribe medications” to help cancer survivors cope with persistent symptoms, said Du. “But for cancer -related fatigue, exercise can work better than pharmaceutical interventions.”
Even so, exercise can be a bandage solution, said Unger, treating only the symptom and not the root cause. Future research needs to investigate why women experience worse side effects after cancer so that they can benefit from more effective treatment options.
Meanwhile, Gotay said he hopes that the study helps normalize the idea that it is fine not feeling good after surviving cancer, which can be difficult for many survivors to understand and accept.
“When people survive cancer and have fatigue or depression, they think something is wrong with them because they are not grateful,” Gotay said. “But they should not feel alone … or as if they were deficient. It is part of all the experience … and we need to start giving them the tools they need to make their lives as rich as possible.”
