The National Institute on Aging reports that 6 out of every 10 falls occur inside the home. Having a fall can be troublesome for most, but cancer survivors can have heightened complications from a fall. Therefore, they should be increasingly mindful of reducing fall risk. The American Cancer Society has reported that cancer survivors have a 25-30% higher rate of falls than the general population. This can be due to a multitude of side effects resulting from cancer treatments.
Chemotherapy-induced peripheral neuropathy (CIPN) is the second most common side effect reported by patients undergoing cancer treatments. Aside from causing pain in the extremities, it can also leave individuals with decreased sensation in their hands and feet. CIPN has been associated with a 41% increase in falls. Fatigue is another factor to consider, one study showed that women who reported fatigue were two times more likely to report a fall.
Other treatment side effects that can increase fall risk include muscle weakness, general deconditioning and chemo-induced cognitive impairment “chemo brain”. Individual factors such as being over the age of 65, having a history of falls, gait and balance deficits, taking more than 3 medications daily and decreased vision or dizziness upon standing may also play a role in increasing fall risk. If you can identify 1 or more of these risk factors, it is important to assess your home environment to identify potential hazards.
To start, assure proper lighting throughout the house. Use automatic nightlights that come on with movement or a timer. Make sure pathways to the bathroom or kitchen are well lit and free of clutter at night. It is important to get a vision check-up regularly and update vision prescriptions as recommended. Use an assistive device when appropriate.
Wall walking or reaching out for furniture may seem quick and easy at the time, but it’s an invitation for a fall. Assure sturdy handrails along stairs, in the shower and toilet areas. Use a non-slip mat in the shower or utilize a shower chair if needed. Be sure to secure area rugs or remove them from the home. Remove items in highly trafficked areas such as clutter, coffee tables or power cords. Place items around the home within easy reach and avoid having to use a step stool or squatting down to obtain objects.
Pets are wonderful company, just stay cognizant when walking about if you have these small companions around your feet. Of course, my favorite way to reduce falls is to stay active. Staying active can improve coordination and strength, it can decrease fatigue levels, which can in turn reduce your risk for falls. If you feel limited in your ability to maintain activity due to fear of falling or other individual factors, you may benefit from a referral to a rehab professional.
For any questions about oncology rehabilitation please feel free to contact me at 386-425-3898 or ashley.perry@halifax.org.
Ashley Perry, PT, DPT, MTC Oncology Rehabilitation Navigator
References: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based [online]. Accessed August 5, 2016. Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ. Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast cancer research and treatment. 2016;159(2):327-333. Wood, L. J., Winters-Stone, K. M., Kneiss, J. A., Fox, A. B., & Walker, R. K. (2020). Women With Clinically Significant Fatigue After Breast Cancer Treatment Report Increased Falls and Perform Poorly on Objective Measures of Physical Fitness and Function. Rehabilitation Oncology, 38(2), 92–99. doi: 10.1097/01.reo.0000000000000193
