Age- and Treatment-Related Patterns in Fatigue, Coping/Resilience, and Skeletal Muscle Bioenergetics (31P-MRS τPCr) in Cancer Survivors: Exploratory Pilot Analysis

Background: Cancer-related health outcomes are shaped by the interplay of aging, complex treatment exposures, and individual psychological characteristics. Mitochondrial dysfunction has been implicated as an underlying biological process affecting cancer-related outcomes. This secondary, exploratory pilot analysis aimed to examine age- and treatment-related differences in fatigue, coping self-efficacy, resilience, and skeletal muscle mitochondrial oxidative capacity, measured via phosphorus-31 magnetic resonance spectroscopy (31P-MRS). Methods: Eleven cancer survivors (mean age 53.3 ± 12.7 years) were recruited from a larger symptom management trial. Participants underwent 31P-MRS to assess mitochondrial function via phosphocreatine recovery time constant (τPCr). Patient-reported outcome measures and physical function assessments were collected. Group comparisons and correlation analyses were conducted to evaluate differences and associations based on age (