This AI tool could analyze a photo of your face to predict the biological age of cancer patients. (Chayanit/Shutterstock)
In a nutshell
- Cancer patients tend to “look” biologically older than their actual age, and this visual age difference, captured by an AI system called FaceAge, can strongly predict their survival odds across multiple cancer types.
- FaceAge outperformed doctors’ estimates and existing clinical tools when it came to forecasting life expectancy in terminally ill patients, offering a more objective way to guide treatment decisions.
- The AI’s age predictions were linked to real biological aging markers, including a significant genetic association with CDK6, a gene involved in cellular senescence, suggesting the tool may be measuring more than just surface-level appearance.
BOSTON — What if a simple photo of your face could reveal how long you might live? Scientists have developed an artificial intelligence system called FaceAge that can estimate a person’s “biological age” from facial photographs, potentially revolutionizing how doctors make life-or-death treatment decisions for cancer patients.
The international study, published in The Lancet Digital Health, found that cancer patients typically “look” about five years older than their actual chronological age. Those who appeared significantly older faced worse survival prospects, regardless of their actual age, cancer type, or other medical factors.
The research team explains that their AI model enhances cancer survival predictions by analyzing facial photographs to determine biological age based on visible features. This work is a collaboration between teams from Harvard Medical School and Maastricht University in the Netherlands.
Doctors often rely on subjective impressions when deciding if elderly or frail cancer patients can withstand aggressive treatments. FaceAge could provide objective data to support these critical choices, potentially saving lives by identifying who might benefit most from different treatment approaches.
How Your Face Reveals Your “True” Age
This graphic is a representation of how FaceAge might be calculated from a photo of a patient. The patient in this photo is AI-generated. Click to expand. (Credit: Mass General Brigham)
We all know people who look significantly younger or older than their actual age. This isn’t just cosmetic; it reflects how quickly a person is aging biologically due to genetics, lifestyle factors like smoking, and disease processes.
The research team developed FaceAge by training a deep learning system on nearly 60,000 face photographs from publicly available databases. The AI analyzes facial features that might indicate biological aging processes not captured by chronological age alone.
After training the system, researchers tested it on over 6,000 cancer patients from the Netherlands and the United States, comparing FaceAge estimates with actual survival outcomes. The findings showed that patients whose FaceAge was significantly older than their chronological age consistently had worse survival rates across multiple cancer types.
Current smokers looked significantly older (by about 33 months on average) than former smokers or those who never smoked. Patients’ body mass index (BMI) showed a surprisingly minimal relationship with FaceAge estimates.
Perhaps most compelling was FaceAge’s performance when predicting survival in patients with terminal cancer. In these cases, making accurate prognostic estimates is crucial for deciding whether to pursue aggressive treatments or focus on comfort care.
The Genetic Connection
The researchers also investigated whether FaceAge might reflect underlying molecular aging processes. They analyzed genetic data from 146 lung cancer patients, focusing on genes associated with cellular senescence, the biological process through which cells stop dividing as they age.
This technology could help determine if aggressive treatments are worth the risk for cancer patients. (© Seventyfour – stock.adobe.com)
The AI’s predictions were linked to a gene called CDK6, which is linked to cellular aging. Past research has shown that CDK6 can slow down the aging process in cells. In this study, people who looked older according to the AI tended to have lower activity in this gene, suggesting the AI might be picking up on real biological signs of aging. However, a person’s actual age didn’t show the same genetic connection.
Medical Decision Making
If this technology becomes mainstream, patients could receive a personalized assessment of how their body might respond to various cancer treatment options within seconds of their doctor taking their photo.
Today, doctors estimate a patient’s physical condition through subjective assessments and standardized but imperfect scales like the Eastern Cooperative Oncology Group (ECOG) performance status. FaceAge could provide a more objective measure, particularly valuable for elderly cancer patients, where the benefits of aggressive treatment must be carefully weighed against risks.
Researchers found that patients with cancer consistently looked older than their actual age across different cancer types, while patients with benign conditions had FaceAge estimates much closer to their chronological age. This suggests the combined effects of cancer and treatment accelerate biological aging processes visible in facial features.
Despite these promising results, significant challenges remain before FaceAge could enter clinical practice. The technology must be extensively validated in diverse populations to ensure it works equally well across different ethnicities, genders, and age groups. The researchers acknowledged potential biases in their training data, which included many photographs of well-known individuals who might have different lifestyle and socioeconomic factors affecting their aging patterns.
Ethical concerns must also be addressed. How would patients feel knowing an algorithm analyzed their face to predict their survival? Could insurance companies misuse such technology for determining coverage? These questions will require careful consideration as the technology develops.
Nevertheless, FaceAge could blend artificial intelligence and medicine to transform cancer technology in ways numbers alone cannot capture. Tools like FaceAge could help ensure patients receive the most appropriate care for their biological, not just chronological, age.
