Chemotherapy used to treat breast cancer may accelerate biological aging and increase the risk of developing age-related health conditions, according to new research from Georgetown University Medical Center.
The study found that women receiving the most cell-damaging chemotherapy regimens could lose an average of 9.4 remaining years of life due to the earlier onset of aging-related diseases.
Published on November 10, 2026, in JAMA Network Open, the research used population-based simulation modelling to examine the long-term balance between the survival benefits of chemotherapy and its potential effects on biological aging.
Chemotherapy May Cause Long-Term Cellular Damage
Although chemotherapy improves survival for many women with breast cancer, certain treatments can also damage healthy cells and tissues.
According to the researchers, this damage may accelerate biological aging, potentially increasing the likelihood of conditions such as frailty and cognitive impairment.
The effects may continue for years after treatment, even when they are not immediately visible.
“Female breast cancer survivors comprise the single largest segment of the 18.6 million cancer survivors in the United States. However, some forms of chemotherapy that extend survival have triggered a secondary crisis: treatment-induced molecular damage to the body’s cells and organs, causing acceleration of biological age,” said Jeanne Mandelblatt, senior author of the study and director of Georgetown Lombardi’s Institute for Cancer and Aging Research (I-CARE).
“Chemotherapy-induced biologic aging can persist for years, and the effects of this acceleration are not visible for many years.”
Researchers Examine Biological Aging Through the p16 Protein
The research team investigated the relationship between chemotherapy and levels of the p16 protein in the blood. This protein is commonly used as a biomarker of cellular senescence, a process in which damaged cells stop dividing but resist normal cell death.
These senescent cells can release biological molecules that contribute to inflammation and damage surrounding tissues, potentially increasing the risk of age-related diseases.
“The key to our methodology is accounting for the fact that while chemotherapy improves breast cancer survival, treatment can also increase damage to normal tissues. This affects many aging systems, including increasing the number of senescent cells, which are damaged cells that have stopped dividing and are also resistant to cell death,” explained Swarnavo Sarkar, the study’s lead author and an I-CARE researcher.
“Senescent cells secrete biological molecules that cause several aging-related diseases through added tissue damage and inflammation.”
The researchers used published evidence linking chemotherapy exposure with changes in blood p16 protein levels to estimate biological aging over the remaining lifetimes of breast cancer survivors.
They selected p16 because previous research provides substantial data on its relationship with cellular senescence. Laboratory evidence has also suggested that clearing cells with high p16 levels could extend lifespan.
Highly Cytotoxic Chemotherapy Linked to 9.4 Years of Lost Life
The researchers developed a population simulation model covering women aged 30 to 79. It compared chemotherapy regimens associated with higher and lower levels of cellular damage and estimated their effects on biological aging.
The analysis found that women receiving the most cytotoxic chemotherapy regimens were estimated to lose an average of 9.4 remaining life years because of the earlier development of aging-related diseases.
The researchers emphasised that the estimate reflects the model’s assessment of long-term health consequences rather than a direct measurement of lifespan in a clinical trial.
The study represents the first attempt to estimate the lifetime balance between breast cancer survival benefits and potential biological aging effects using population-based simulation modelling.
Researchers Call for Personalised Care After Cancer Treatment
The findings could help guide future research into monitoring biological aging among breast cancer survivors after chemotherapy.
Mandelblatt suggested that measuring biological age following treatment could eventually help doctors develop personalised survivorship care plans to reduce long-term health risks.
Physical activity and certain medications already being investigated for other purposes have shown potential to slow accelerated aging in cancer survivors. Researchers hope that future interventions could help recover some of the healthy life years potentially lost through treatment-related aging.
The study was made possible through the Cancer Intervention and Surveillance Modeling Network (CISNET), a National Cancer Institute-sponsored consortium that uses simulation models to examine the effects of cancer prevention, screening, and treatment on population health.
Future Research to Examine Other Cancer Treatments
The research team plans to expand its modelling approach to include other breast cancer treatments, including radiotherapy, immunotherapy, targeted therapies, and hormonal treatments.
These therapies may also contribute to accelerated biological aging, with effects that could persist long after treatment ends.
“There are two next steps we are planning, the first being expanding the scope of this methodology for other types of breast cancer treatments, such as radiotherapy, immunotherapies, targeted therapies and hormonal treatments, which also appear to speed up aging, with effects potentially lasting for many years after treatment,” Sarkar said.
“We also plan to include information about survivor characteristics to help guide future conversations about individual outcomes.”
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