Colorectal Cancer Risk in Patients with Breast Cancer Survivors: Evidence from a Comprehensive Cancer Center

Breast cancer survival rates are lower in African Americans (AAs) than in Caucasians, owing in part to a higher prevalence of obesity in the former, which increases the risk of recurrence and mortality. The Women’s Intervention Nutrition Study (WINS) found that Caucasian women who followed a low-fat eating plan experienced a lower rate of cancer recurrence than women who maintained their usual diets. The purpose of this study was to test the feasibility of a WINS plan tailored to the cultural needs of AA breast cancer survivors. This feasibility pilot study was conducted at a university National Cancer Institute-designated comprehensive cancer center outpatient clinic with AA breast cancer survivors. The culturally specific WINS (WINS-c) plan included eight individual counseling sessions, five educational group meetings, and follow-up telephone calls over a 1-year period. Outcome measures included dietary fat, triglyceride, insulin and glucose levels, and fruit and vegetable intake. Participants ( n = 8) had a mean age of 61.1 years (standard error of the mean (SEM) 3.1 years) and a mean BMI of 32 kg/m2 (SEM 4.25 kg/m)2. Baseline daily fat consumption decreased from 64.6 g (range 36.8–119.6g) to 44.0 g (21.6–73.4g) at 52 weeks ( p = 0.07). Mean daily consumption of fruits and vegetables increased by 36% and 15%, respectively. Mean triglyceride levels decreased at 12 months ( p < 0.05). Sustained hyperinsulinemia was noted in most participants, including those without diabetes. Mean calcium and vitamin D consumption decreased over the 1-year study period. In AA breast cancer survivors, the WINS-c program resulted in a trend toward reduced fat consumption and may represent a sustainable approach in this population for improvement of diet quality after breast cancer.

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Mindfulness-Based Stress Reduction for Breast Cancer Survivors (MBSR (BC)): Evaluating Mediators of Psychological and Physical Outcomes in a Large Randomized Controlled Trial

10.1101/2020.05.05.20092171 ◽

2020 ◽

Author(s):

Cecile A. Lengacher ◽

L. Forest Gruss ◽

Kevin E. Kip ◽

Richard R. Reich ◽

Manolete S. Moscoso ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Perceived Stress ◽

National Cancer Institute ◽

Breast Cancer Survivors ◽

South Florida ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Cognitive Mechanisms ◽

Link Type

ABSTRACTMBSR(BC) is known to have a positive impact on psychological and physical symptoms among breast cancer survivors (BCS). However, the cognitive mechanisms of “how” MBSR(BC) works are unknown. The purpose of this study, as part of a larger R01 trial, was to test whether positive effects achieved from the MBSR(BC) program were mediated through changes in increased mindfulness, decreased fear of breast cancer recurrence, and perceived stress. Female BCS >21 years diagnosed with Stage 0-III breast cancer were randomly assigned to a 6-week MBSR(BC) or a Usual Care(UC) regimen. Potential outcome mediators were identified by use of an analysis of covariance (ANCOVA), comparing mean values of outcome variables and potential mediating variables followed by mediational and bootstrap analyses. Among 322 BCS (167 MBSR(BC) and 155 UC), fear of recurrence and perceived stress, but not mindfulness, mediated reductions in anxiety and fatigue at weeks 6 and 12, partially supporting our hypothesis of cognitive mechanisms of MBSR(BC).Support: This study was supported by the National Cancer Institute (Award Number 1R01 CA131080-01A2). This work also has been supported in part by the Biostatistics and Bioinformatics Shared Resource at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. This study protocol was approved by the Institutional Review Board at the University of South Florida to ensure the ethical treatment of participants.Conflict of Interest: The authors have no conflicts to report.Trial Registration:www.ClinicalTrials.gov Registration Number: NCT01177124

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Weight change after (neo)adjuvant chemotherapy in a cohort of breast cancer survivors: Trends by race, hormone positivity, and chemotherapy regimen.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e12018 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e12018-e12018

Author(s):

Bradley S Colton ◽

Samuel Kareff ◽

Shaw Li ◽

Princess Alintah ◽

Chiranjeev Dash ◽

...

Keyword(s):

Breast Cancer ◽

Weight Gain ◽

Adjuvant Chemotherapy ◽

Cancer Survivors ◽

Weight Change ◽

Breast Cancer Survivors ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Her2 Status ◽

Limited Information

e12018 Background: It is estimated that over 50% of breast cancer survivors gain weight during treatment; patients receiving chemotherapy are at higher risk for weight gain. Previous studies have reported limited information about weight gain with current chemotherapy regimens. Methods: Individual data were collected from a cohort of 98 breast cancer patients treated with neoadjuvant or adjuvant chemotherapy between 2015 and 2017 at Lombardi Comprehensive Cancer Center. Weight was recorded from baseline visits and ≥ 1 visit following completion of chemotherapy. Regimens were grouped into anthracycline- (AC) and non-anthracycline-based (NAC) chemotherapy. Results: Overall, 49% ( n = 48) of patients gained weight after chemotherapy, though African-American patients demonstrated higher baseline BMI. Patients with ER-positive cancers displayed greater weight gain than hormone-negative counterparts ( p = 0.04); PR- or HER2-status was not associated statistically significant changes in weight ( p = 0.12 and 0.82, respectively). Among patients who did gain weight, NAC was associated with greater weight gain (4.47kg) than AC-based regimens (2.54kg) ( p = 0.03). Conclusions: ER positivity and NAC may serve as independent predictors of weight gain during chemotherapy. Further studies might consider further analyzing these trends to demonstrate additional long-term patterns. Baseline and After Chemotherapy BMI (kg/m2) and Weight Change (kilograms and percentage change) (P* derived from ANOVA). [Table: see text]

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Sleep problems in breast cancer survivors 1–10 years posttreatment

Palliative & Supportive Care ◽

10.1017/s1478951517000311 ◽

2017 ◽

Vol 16 (3) ◽

pp. 325-334 ◽

Cited By ~ 17

Author(s):

Amy E. Lowery-Allison ◽

Steven D. Passik ◽

Matthew R. Cribbet ◽

Ruth A. Reinsel ◽

Barbara O'Sullivan ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Sleep Problems ◽

Physical Symptoms ◽

Stage I ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Vasomotor Symptoms ◽

Poor Sleep

ABSTRACTObjective:Sleep can affect quality of life (QoL) during cancer survivorship, and symptoms related to poor sleep can be exacerbated. We examined the prevalence, severity, and nature of subjective sleep complaints in women surviving stage I–III breast cancer who were 1–10 years posttreatment. We also examined the demographic, medical, physical, and psychosocial correlates of poor sleep in these women in order to identify the subgroups that may be most in need of intervention.Method:A total of 200 patients at a comprehensive cancer center who were 1–10 years posttreatment for primary stage I–III breast cancer with no evidence of disease at the time of enrollment completed a battery of questionnaires on demographics, sleep, physical symptoms, mood, cancer-specific fears, and QoL.Results:The women had a mean age of 57 years (SD = 10.0), with a mean of 63.3 months (SD = 28.8) of post-cancer treatment. Some 38% of these patients were identified as having poor-quality sleep. Women with poor sleep took longer to fall asleep, had more awakenings, and acquired 2 hours less sleep per night than those with good sleep. They also had a lower QoL, greater severity of pain, more concerns about health and recurrence, and increased vasomotor symptoms (p < 0.05). Daytime sleepiness and depression were found to be not significantly correlated with sleep quality.Significance of results:Many breast cancer survivors had severe subjective insomnia, and several breast cancer survivor subgroups were identified as having members who might be most in need of sleep-improvement interventions. Addressing physical symptoms (e.g., vasomotor symptoms and pain) and providing education about the behavioral, social, environmental, and medical factors that affect sleep could result in substantial improvement in the life course of breast cancer survivors.

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Breast cancer survivors' attitudes about communication of breast cancer risk to their children

American Journal of Medical Genetics ◽

10.1002/ajmg.c.10012 ◽

2003 ◽

Vol 119C (1) ◽

pp. 45-50 ◽

Cited By ~ 22

Author(s):

Susan Miesfeldt ◽

Wendy F. Cohn ◽

Susan M. Jones ◽

Mary E. Ropka ◽

Jenine C. Weinstein

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cancer Survivors ◽

Breast Cancer Survivors

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Sedentary Behaviors and Biomarkers Among Breast Cancer Survivors

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0045 ◽

2018 ◽

Vol 15 (1) ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Sheri J. Hartman ◽

Catherine R. Marinac ◽

Lisa Cadmus-Bertram ◽

Jacqueline Kerr ◽

Loki Natarajan ◽

...

Keyword(s):

Breast Cancer ◽

Insulin Resistance ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cancer Survivors ◽

Sedentary Behavior ◽

Breast Cancer Survivors ◽

Sitting Time ◽

Sedentary Behaviors ◽

Sit To Stand

Background: Sedentary behavior is associated with increased risk of poor outcomes in breast cancer survivors, but underlying mechanisms are not well understood. This pilot study explored associations between different aspects of sedentary behaviors (sitting, prolonged sitting, sit-to-stand transitions, and standing) and breast cancer risk-related biomarkers in breast cancer survivors (n = 30). Methods: Sedentary behavior variables were objectively measured with thigh-worn activPALs. Breast cancer risk-related biomarkers assessed were C-reactive protein (CRP), insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and were measured in fasting plasma samples. Linear regression models were used to investigate associations between sedentary behavior variables and biomarkers (log CRP, insulin, and HOMA-IR). Results: Sit-to-stand transitions were significantly associated with insulin resistance biomarkers (P < .05). Specifically, each 10 additional sit-to-stand transitions per day was associated with a lower fasting insulin concentration (β = −5.52; 95% CI, −9.79 to −1.24) and a lower HOMA-IR value (β = −0.22; 95% CI, −0.42 to −0.03). Sit-to-stand transitions were not significantly associated with CRP concentration (P = .08). Total sitting time, long sitting bouts, and standing time were not significantly associated with CRP, insulin, or HOMA-IR (P > .05). Conclusions: Sit-to-stand transitions may be an intervention target for reducing insulin resistance in breast cancer survivors, which may have favorable downstream effects on cancer prognosis.

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P4-12-15: Cancer Survivor Care: An Evaluation of a Group Visit Model of Care for Breast Cancer Survivors at Duke Cancer Center.

10.1158/0008-5472.sabcs11-p4-12-15 ◽

2011 ◽

Author(s):

KJ Trotter ◽

S Schneider

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Cancer Survivor ◽

Breast Cancer Survivors ◽

Cancer Center ◽

Model Of Care ◽

Group Visit

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Effects of Tomato and Soy on Serum Adipokine Concentrations in Postmenopausal Women at Increased Breast Cancer Risk: A Cross-Over Dietary Intervention Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-3222 ◽

2014 ◽

Vol 99 (2) ◽

pp. 625-632 ◽

Cited By ~ 6

Author(s):

Adana A. Llanos ◽

Juan Peng ◽

Michael L. Pennell ◽

Jessica L. Krok ◽

Mara Z. Vitolins ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Postmenopausal Women ◽

Body Mass ◽

Dietary Intervention ◽

Serum Adiponectin ◽

Comprehensive Cancer Center ◽

Cancer Center

Context: Breast cancer risk among postmenopausal women increases as body mass index increases. Practical preventive methods to reduce risk of breast cancer are lacking. Few studies have investigated the effects of carotenoids and isoflavones on circulating adipokines in postmenopausal women. Objective: The aim was to examine the effects of lycopene- and isoflavone-rich diets on serum adipokines. Design: This was a 26-week, two-arm, longitudinal crossover trial. Setting: Participants were recruited from clinics at The Ohio State University Comprehensive Cancer Center. Participants: Seventy postmenopausal women at increased breast cancer risk participated in the study. The mean age and body mass index of participants was 57.2 years and 30.0 kg/m2, respectively; the study was comprised of 81.4% whites. Interventions: The interventions included 10 weeks of consumption of a tomato-based diet (≥25 mg lycopene daily) and 10 weeks of consumption of a soy-based diet (≥40 g of soy protein daily), with a 2-week washout in between. Main Outcome Measures: Changes in serum adiponectin, leptin, and the adiponectin to leptin ratio were examined for each intervention through linear mixed models, with ratio estimates corresponding to postintervention adipokine concentrations relative to preintervention concentrations. Results: After the tomato intervention, among all women, adiponectin concentration increased (ratio 1.09, 95% confidence interval (CI) 1.00–1.18), with a stronger effect observed among nonobese women (ratio 1.13, 95% CI 1.02–1.25). After the soy intervention, adiponectin decreased overall (ratio 0.91, 95% CI 0.84–0.97), with a larger reduction observed among nonobese women (ratio 0.89, 95% CI 0.81–0.98). Overall, no significant changes in leptin or the adiponectin to leptin ratio were observed after either intervention. Conclusions: Increasing dietary consumption of tomato-based foods may beneficially increase serum adiponectin concentrations among postmenopausal women at increased breast cancer risk, especially those who are not obese. Additional studies are essential to confirm these effects and to elucidate the specific mechanisms that may make phytonutrients found in tomatoes practical as breast cancer chemopreventive agents.

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