Addressing the challenge of accelerated aging in breast cancer survivors

More women are surviving breast cancer than ever before, which is a remarkable success in cancer treatment. However, researchers are increasingly finding that cancer treatments can accelerate the biological aging process, leading to earlier onset and higher rates of declines in function, health and well-being, compared to the general population. This phenomenon, known as accelerated aging, can impact quality of life, independence and even lifespan.

Given the expected rise in the number of older survivors with breast cancer — more than 6 million by 2040 — understanding the mechanisms of accelerated aging and developing strategies to prevent it is imperative.

Mina Sedrak, MD, MS, an internationally recognized physician-scientist and associate professor of medicine at the David Geffen School of Medicine at UCLA, is leading the charge to address this challenge. His research focuses on the complex relationship between cancer treatment and the aging process to unravel the biological mechanisms underlying accelerated aging in people with cancer. He designs and develops clinical trials to test innovative, biology-driven geroprotective therapeutic interventions aimed at mitigating and preventing accelerated aging in cancer patients.

In this Q&A, Dr. Sedrak, who directs the Cancer and Aging Program at the UCLA Health Jonsson Comprehensive Cancer Center, discusses what inspired his work, the challenges cancer survivors face as they age, and the exciting advancements in cancer and aging research that could reshape patient care in the years to come.

Q: First, what inspired you to focus on cancer and aging in your research?

Dr. Sedrak: I was inspired to focus on cancer and aging in my research after having the fortune of working with an extraordinary leader in oncology, Dr. Arti Hurria.

Arti wasn’t just my mentor; she was my inspiration. She approached her work with a rare intensity, driven by a mission to transform the care of older adults with cancer. For her, it wasn’t enough to treat the disease — she was committed to improving the quality of life of older adults. Her passion was infectious. She helped me see that our work wasn’t just about fighting cancer but about understanding how treatments affect a patient’s health and well-being, especially as they age.

My time with Arti ignited my passion for cancer and aging research. I became fascinated by the ways cancer treatments accelerate the aging process, leaving survivors frailer and more vulnerable. The questions that drove me then — and still drives me today — is why does this happen and how can we prevent it? How can we not only extend life but ensure those years are healthy and fulfilling?

When Arti tragically passed away in a car accident in November 2018, it shook me deeply. It was a pivotal moment in my life and career. My work suddenly became more personal, more urgent. It wasn’t just about the science — it became my mission to carry on her legacy. I felt a deep responsibility to ensure that as more people survive cancer, they don’t have to sacrifice their health and vitality along the way. That’s the heart of everything I do in my research today.

Q: What problem are you trying to solve?

Dr. Sedrak: The problem I’m trying to solve is understanding why accelerated aging happens after cancer treatment and how can we prevent it. 

While we've made tremendous progress in improving cancer survival rates, curing or controlling the disease doesn’t always mean patients are living healthier lives. Yes, many cancer survivors are living longer today, but they’re often burdened with chronic conditions, frailty and functional decline. They survive, but they struggle — and that’s not good enough. We need to find better solutions to help them live well, not just longer.

Our hypothesis is that cancer treatments, while successful in treating the cancer, have unintended consequences at the cellular and molecular levels. We have shown that cancer treatment can accelerate the aging processes, reducing patients' physiologic and organ reserves, and making them more vulnerable than someone of the same age who hasn’t undergone cancer treatment. We call this accelerated aging because it's happening at a much faster rate than normal aging would for someone without cancer and without the treatment burden. 

Accelerated aging is a significant issue we need to tackle head-on. Our goal isn’t just to extend life, but to improve the quality of that life. We want both quantity and quality for our patients. To achieve this, we must address the consequences of accelerated aging caused by cancer treatments. That’s the challenge we face, and it’s what drives my research.

Q: What impact do cancer treatments have on the aging processes of patients, particularly regarding cellular senescence and its effects on health outcomes?

Dr. Sedrak: Studies show that cancer patients are more likely to experience accelerated aging compared to individuals without cancer. Cancer treatments like chemotherapy and radiation, while effective at treating the disease, can cause damage to cells in ways that mimic or even accelerate the normal aging process. Essentially, these treatments disrupt the body’s natural aging mechanisms.

One of the ways cancer treatments affect aging is through a process called cellular senescence. Normally, when cells become damaged, they enter a cell state called senescence, where they stop dividing, but do not die. Rather, these cells remain alive and active, releasing pro-inflammatory proteins known as SASP (Senescence-Associated Secretory Phenotype). Early in life, senescent cells and SASP help protect us by preventing damaged cells from becoming cancerous and causing our immune system to clean up the damage. However, as we age, more and more of these damaged cells build up in our tissues, causing chronic inflammation, tissue damage, and ultimately age-related organ dysfunction.

Cancer treatments accelerate aging by causing senescent cells to accumulate at a much earlier and faster buildup than would occur with normal aging. This accelerated buildup of senescent cells leads to worse health outcomes. Survivors find themselves aging faster than their peers who haven’t undergone cancer treatment.  

Understanding and addressing this issue is critical. We need to not only treat cancer but also help patients live longer, healthier lives — free from the burden of accelerated aging. That’s why our research focuses on exploring ways to intervene, targeting the senescent cells and potentially reversing or preventing some of the damage that contributes to these aging-related declines in health.

Q: Are you using drugs to target senescent cells?

Dr. Sedrak: Yes, our team, in collaboration with others, is exploring a promising new class of drugs called senolytics, which specifically target and remove senescent cells. These drugs work by triggering senescent cells to undergo apoptosis — essentially prompting them to self-destruct. Senolytics are being tested in a range of age-related conditions, such as diabetes, osteoarthritis and Alzheimer's disease, and now we are investigating their potential benefits in reducing accelerated aging in cancer survivors.

At the UCLA Cancer and Aging Program, we are leading two clinical trials focused on breast cancer survivors — particularly post-menopausal women who have undergone chemotherapy and are now facing declines in physical function. In the first study, we are testing the effectiveness of senolytics in frail women following chemotherapy, to see if the drug can improve their physical capabilities. 

In our second study, we’re looking at the combination of senolytics and exercise in pre-frail women. We are randomizing patients into four groups: senolytics plus exercise, senolytics alone, exercise alone, or placebo. This allows us to explore how these interventions, either alone or in combination, impact physical function. In both trials, the main outcome we are focused on is the change in physical function from before treatment to after, to determine whether senolytics can help improve patients' ability to function in their daily lives.

Q: How do you envision your research improving the quality of life for patients in the future?

Dr. Sedrak: Many of my patients come to me with real concerns — fatigue, weakness, memory problems, or simply not being able to do what they once loved, like playing with their grandchildren or staying active. These issues are frustrating, and while we often recommend behavioral interventions such as more exercise, the reality is that many patients struggle to follow through. Whether it’s due to lingering side effects from their treatments, physical limitations, or just feeling too overwhelmed, they’re not always able to stick with exercise programs. We know exercise can be beneficial, but we don’t fully understand why it works for some and not for others, or how to better support those who can’t engage in it due to the toll cancer and its treatments have taken on their bodies.

What drives my research is the hope that we can go beyond the generic advice to “exercise more,” and instead offer real, practical solutions that meet patients where they are. By taking what we learn in the lab, I believe we can develop more precise geroprotective interventions that directly reduce accelerated biological aging processes. This isn’t about one-size-fits-all recommendations — it’s about providing patients with tools that genuinely work for them, based on their unique needs and circumstances.

In oncology, we’ve done an excellent job focusing on the tumor. Precision medicine has allowed us to target the right treatment for the right cancer. But I believe we need to shift toward precision health, where we focus not only on the tumor but also on the person who carries it. This means understanding each patient’s biology, their environment and the challenges they face as individuals. When we can tailor treatments not just to the disease but to the whole person, we can help optimize their health before, during and after cancer treatment.

Ultimately, I see a future where we aren’t just helping patients survive cancer — we’re helping them get back to living their lives fully. My goal is to build their resilience so that, after treatment, they can bounce back and continue doing the things that matter most to them. It’s not just about surviving; it’s about thriving.

Q: What advancements in cancer and aging research are you most excited about in the coming years?

Dr. Sedrak: I’m most excited about the potential to identify targetable cellular and molecular pathways of aging that we can modify. Imagine if we could not only extend people’s lifespans but also improve their health span — helping them live longer, healthier lives with minimal periods of disease or disability. Right now, people may live longer, but many spend their later years battling chronic illness, frequent hospital visits and a loss of independence. My hope is that we can shorten that period of decline at the end of life, so people can enjoy their later years feeling vibrant and healthy, rather than managing illness.

What excites me the most is that cancer and aging research is part of a much bigger puzzle. By studying the relationship between cancer and aging, we can uncover insights that may translate to other diseases, like diabetes, heart disease and even HIV. For instance, HIV patients are living longer due to treatment advancements, but they aren’t necessarily living healthier — they face more comorbidities and frailty than their peers. Similarly, cancer is an ideal model to study aging because cancer treatments accelerate the aging process.

If we can better understand the biology of aging, we could improve outcomes not just for cancer survivors but for people facing a variety of age-related diseases like Alzheimer’s, diabetes and more. It’s just one piece of a larger puzzle, but cancer gives us a unique window into understanding how aging works. The insights we gain from cancer patients and survivors could have a significant impact on public health, improving the quality of life for a wide range of people as they age.

Q: What made you decide to come to UCLA? 

Dr. Sedrak: UCLA offers incredible opportunities to make a lasting impact in oncology. There’s a strong history here of translating discoveries from the lab into real-world clinical applications, like the groundbreaking work of pioneers such as Drs. Dennis Slamon, Antoni Ribas and Aditya Bardia. My goal is to create large-scale impact that truly improves patients’ lives, and UCLA has a proven track record of doing just that.

I came to UCLA because I want to lead research that not only advances science but transforms the way we care for people. I’m driven by the belief that we can change the future for cancer survivors — not just by extending life, but by enhancing its quality. UCLA gives me the platform to turn that vision into reality, and I feel humbled and privileged to work alongside such talented colleagues, collaborators and friends who share this mission.