scholarly journals Breast cancer chemotherapy vascular toxicity: A review of mediating mechanisms and exercise as a potential therapeutic

2021 ◽  
Author(s):  
Marie Mclaughlin ◽  
Geraint Florida-James ◽  
Mark Ross
Keyword(s):  
Breast Cancer ◽  
Cancer Chemotherapy ◽  
Potential Role ◽  
Vascular Toxicity ◽  
Exercise Interventions ◽  
Breast Cancer Chemotherapy ◽  
Mediating Mechanisms ◽  
The Impact ◽  
Health Function

Breast cancer chemotherapy, although very potent against tumour tissue, results in significant cardiovascular toxicity. The focus of research in this area has been predominantly towards cardiotoxicity. There is limited evidence detailing the impact of such treatment on the vasculature despite its central importance within the cardiovascular system and resultant detrimental effects of damage and dysfunction. This review highlights the impact of chemotherapy for breast cancer on the vascular endothelium. We consider the most likely mechanisms of endothelial toxicity to be through direct damage and dysfunction of the endothelium. There are sharp consequences of these detrimental effects as they can lead to cardiovascular disease. However, there is potential for exercise to alleviate some of the vascular toxicity of chemotherapy, and the evidence for this is provided. The potential role of exercise in protecting against vascular toxicity is explained, highlighting the recent in-human and animal model exercise interventions. Lastly, the mediating mechanisms of exercise protection of endothelial health is discussed, focusing on the importance of exercise for endothelial health, function, repair, inflammation and hyperlipidaemia, angiogenesis, and vascular remodelling. These are all important counteracting measures against chemotherapy-induced toxicity and are discussed in detail.

scholarly journals Patient and Physician Decision Styles and Breast Cancer Chemotherapy Use in Older Women: Cancer and Leukemia Group B Protocol 369901

2012 ◽  
Vol 30 (21) ◽  
pp. 2609-2614 ◽  
Author(s):  
Jeanne S. Mandelblatt ◽  
Leigh Anne Faul ◽  
George Luta ◽  
Solomon B. Makgoeng ◽  
Claudine Isaacs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Chemotherapy ◽  
Older Patients ◽  
Treatment Decision ◽  
Point Change ◽  
Decision Style ◽  
Breast Cancer Chemotherapy ◽  
Patient Decision ◽  
Decision Styles ◽  
The Impact

Purpose Physician and patient decision styles may influence breast cancer care for patients ≥ 65 years (“older”) because there is uncertainty about chemotherapy benefits in this group. We evaluate associations between decision-making styles and actual treatment. Methods Data were collected from women treated outside of clinical trials for newly diagnosed stage I to III breast cancer (83% response) from January 2004 through April 2011 in 75 cooperative group sites. Physicians completed a one-time mailed survey (91% response), and clinical data were abstracted from charts. Patient decision style was measured on a five-point scale. Oncologists' preference for prescribing chemotherapy was based on standardized vignettes. Regression and multiple imputation were used to assess associations between chemotherapy and other variables. Results There were 1,174 women seen by 212 oncologists; 43% of women received chemotherapy. One-third of women preferred to make their own treatment decision. Patient and physician decision styles were independently associated with chemotherapy. Women who preferred less physician input had lower odds of chemotherapy than women who preferred more input (odds ratio [OR] = 0.79 per 1-point change; 95% CI, 0.65 to 0.97; P = .02) after considering covariates. Patients whose oncologists had a high chemotherapy preference had higher odds of receiving chemotherapy (OR = 2.65; 95% CI, 1.80 to 3.89; P < .001) than those who saw oncologists with a low preference. Conclusion Physicians' and older patients' decision styles are each associated with breast cancer chemotherapy use. It will be important to re-evaluate the impact of decision styles when there is greater empirical evidence about the benefits and risks of chemotherapy in older patients.

scholarly journals Narrowing racial gaps in breast cancer chemotherapy initiation: the role of the patient–provider relationship

2013 ◽  
Vol 139 (1) ◽  
pp. 207-216 ◽  
Author(s):  
Vanessa B. Sheppard ◽  
Claudine Isaacs ◽  
George Luta ◽  
Shawna C. Willey ◽  
Marc Boisvert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Chemotherapy ◽  
Breast Cancer Chemotherapy ◽  
Racial Gaps ◽  
Chemotherapy Initiation

scholarly journals Null effect of circulating sphingomyelins on risk for breast cancer: a Mendelian randomization report using Breast Cancer Association Consortium (BCAC) data

2019 ◽  
Author(s):  
Charleen D. Adams
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Potential Role ◽  
Mendelian Randomization ◽  
Signaling Cascades ◽  
Cancer Etiology ◽  
Null Effect ◽  
Cancer Types ◽  
The Impact

AbstractBackgroundChanges in cellular metabolism are a hallmark of cancer and are linked with sphingolipid synthesis. Due to immense interest in how sphingolipids influence chemoresistance, more is known about the impact of sphingolipids during cancer treatment and progression than about the potential role of sphingolipids in the induction of tumors in humans.MethodsBecause estrogen triggers sphingolipid signaling cascades, the causal role of circulating levels of sphingomyelin (a type of sphingolipid) on breast cancer was investigated with a well-powered Mendelian randomization design.ResultsThe results reveal a null effect (OR = 0.94; 95% CI = 0.85, 1.05; P = 0.30).ConclusionDespite the role sphingomyelins play during chemoresistance and cancer progression, circulating sphingomyelins do not appear to initiate or protect from breast cancer.ImpactThis finding comprises the first causal report in humans that sphingomyelins on breast cancer initiation is null. Future investigations of risk in other cancer types are needed to further explore the potential role of sphingolipid biology in cancer etiology.

scholarly journals Null effect of circulating sphingomyelins on risk for breast cancer: a Mendelian randomization report using Breast Cancer Association Consortium (BCAC) data.

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2119
Author(s):  
Charleen D. Adams
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Potential Role ◽  
Mendelian Randomization ◽  
Signaling Cascades ◽  
Cancer Etiology ◽  
Null Effect ◽  
Cancer Types ◽  
The Impact

Background: Changes in cellular metabolism are a hallmark of cancer and are linked with sphingolipid synthesis. Due to immense interest in how sphingolipids influence chemoresistance, more is known about the impact of sphingolipids during cancer treatment and progression than about the potential role of sphingolipids in the induction of tumors in humans. Methods: Because estrogen triggers sphingolipid signaling cascades, the causal role of circulating levels of sphingomyelin (a type of sphingolipid) on breast cancer was investigated with a well-powered Mendelian randomization design. Results: The results reveal a null effect (OR = 0.94; 95% CI = 0.85, 1.05; P = 0.30). Conclusion: Despite the role sphingomyelins play during chemoresistance and cancer progression, circulating sphingomyelins do not appear to initiate or protect from breast cancer. This finding comprises the first causal report in humans that sphingomyelins on breast cancer initiation is null. Future investigations of risk in other cancer types are needed to further explore the potential role of sphingolipid biology in cancer etiology.

Sign in / Sign up

Export Citation Format

Share Document