scholarly journals The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6-months post-chemotherapy

2021 ◽  
Author(s):  
Amber Kleckner ◽  
Ian R. Kleckner ◽  
Eva Culakova ◽  
Michelle Shayne ◽  
Elizabeth K. Belcher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Repeated Measures ◽  
Diabetes Management ◽  
Menopausal Status ◽  
Secondary Analysis ◽  
Prospective Longitudinal Study ◽  
Cancer Related Fatigue ◽  
Diabetes Status ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Purpose To quantify the impact of diabetes on the trajectory of cancer-related fatigue (CRF) from pre-chemotherapy to 6 months post-chemotherapy for patients with breast cancer compared to non-cancer controls.Methods This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and age-matched women without cancer (controls). CRF was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6-months post-chemotherapy in patients; controls were assessed at equivalent time points. Diabetes status was obtained at baseline. Repeated measures mixed models estimated the association between CRF and diabetes controlling for cancer (y/n), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education.Results A total of 439 patients and 235 controls (age: 52.8±10.5 years) had available data on diabetes status. Diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). Patients had worse fatigue than controls throughout treatment (p<0.001). Diabetes was associated with worse CRF with a clinically meaningful difference of 4.7±1.7 points on the fatigue measure in all participants (p=0.009) and patients alone (p=0.030). For MFSI subdomains, diabetes was associated with worse general (p=0.002), physical (p=0.005), and mental fatigue (p=0.025) but not worse emotional fatigue or vigor (p>0.14) among patients. Conclusions Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe CRF in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address CRF during chemotherapy treatment

scholarly journals Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

2017 ◽  
Vol 35 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Michelle C. Janelsins ◽  
Charles E. Heckler ◽  
Luke J. Peppone ◽  
Charles Kamen ◽  
Karen M. Mustian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Reading Ability ◽  
Menopausal Status ◽  
Prospective Longitudinal Study ◽  
Cognitive Difficulties ◽  
Community Oncology ◽  
Prospective Longitudinal

Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and Methods Patients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. Results Of patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P < .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). Conclusion Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

A prospective longitudinal study of cancer-related fatigue in patients undergoing breast-conserving surgery and radiation with or without chemotherapy for breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9122-9122
Author(s):  
Mylin Ann Torres ◽  
Thaddeus Pace ◽  
Jennifer Felger ◽  
Tian Liu ◽  
Karen D. Godette ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dna Binding ◽  
Inflammatory Mediators ◽  
Inflammatory Responses ◽  
Binding Motif ◽  
Nf Kappa B ◽  
Prospective Longitudinal Study ◽  
Cancer Related Fatigue ◽  
Whole Breast Radiotherapy ◽  
Prospective Longitudinal

9122 Background: We prospectively evaluated risk factors for persistent cancer-related fatigue in women with breast cancer undergoing lumpectomy with or without chemotherapy (CTX) prior to whole breast radiotherapy (XRT). We assessed the potential role of inflammatory mediators, demographic characteristics, and treatment history including CTX. Methods: Following lumpectomy, 60 women received a definitive course of whole breast XRT (50 Gy plus a 10 Gy boost). Prior to XRT, at week 6 of XRT, and 6 weeks post XRT, subjects completed the Multidimensional Fatigue Inventory (MFI) and underwent blood draws for inflammatory mediators (protein and mRNA). Results: Independent multivariate analyses of clinical and demographic factors revealed that CTX (p<.001) , given neoadjuvantly or adjuvantly, and age <50 (p=.03) were significant predictors of higher fatigue scores post XRT. Mean MFI scores in patients treated with CTX (n=24) were 20 points higher than patients not treated with CTX (p<.001) with a clinically meaningful difference in scores being 10 points on the MFI. Gene ontology analysis of differentially expressed genes indicated increased activation of genes involved in immune and inflammatory responses in fatigued vs. non-fatigued patients (p<.001). Of the inflammatory mediators, plasma IL-6 prior to XRT was the strongest predictor of post XRT fatigue (p=.02). Moreover, plasma IL-6 concentrations prior to XRT were significantly higher in patients who received CTX (mean 4.96 vs. 2.53, p=.01). Patients who received CTX also had significantly higher levels of NF Kappa B DNA binding 6 weeks post XRT (p<.001), and transcription factor binding analysis revealed a greater representation of genes with the NF Kappa B DNA binding motif in fatigued vs. non-fatigued patients (p =.05). Conclusions: Collectively, these data suggest an interaction between CTX and XRT leading to inflammation and fatigue several weeks post XRT. This relationship was independent of whether CTX was given pre or post-operatively. Treatments targeting inflammation before XRT may reduce fatigue post therapy, particularly in patients previously treated with CTX.

A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development

2011 ◽  
Vol 26 (8) ◽  
pp. 484-489 ◽  
Author(s):  
A.-L. Sutter-Dallay ◽  
L. Murray ◽  
L. Dequae-Merchadou ◽  
E. Glatigny-Dallay ◽  
M.-L. Bourgeois ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Child Development ◽  
Postnatal Depression ◽  
Repeated Measures ◽  
Maternal Depressive Symptoms ◽  
Prospective Longitudinal Study ◽  
Postnatal Depressive Symptoms ◽  
Prospective Longitudinal ◽  
The Impact

AbstractBackgroundFew studies of the effects of postnatal depression on child development have considered the chronicity of depressive symptoms. We investigated whether early postnatal depressive symptoms (PNDS) predicted child developmental outcome independently of later maternal depressive symptoms.MethodsIn a prospective, longitudinal study, mothers and children were followed-up from birth to 2 years; repeated measures of PNDS were made using the Edinburgh Postnatal Depression Scale (EPDS); child development was assessed using the Bayley Scales II. Multilevel modelling techniques were used to examine the association between 6 week PNDS, and child development, taking subsequent depressive symptoms into account.ResultsChildren of mothers with 6 week PNDS were significantly more likely than children of non-symptomatic mothers to have poor cognitive outcome; however, this association was reduced to trend level when adjusted for later maternal depressive symptoms.ConclusionEffects of early PNDS on infant development may be partly explained by subsequent depressive symptoms.

scholarly journals The impact of radiodermatitis in quality of life of patients with breast cancer during treatment: a prospective longitudinal study

Mastology ◽  
2018 ◽  
Vol 28 (s1) ◽  
pp. 29-29
Author(s):  
Marceila A. Fuzissaki ◽  
◽  
Carlos E. Paiva ◽  
Marco A. Oliveira ◽  
Mariana T. M. Lima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Longitudinal Study ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
The Impact

Cancer-related fatigue in breast cancer survivors: A longitudinal analysis compared to matched controls.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10045-10045 ◽  
Author(s):  
AnnaLynn Williams ◽  
Charles E. Heckler ◽  
Carly Lynn Paterson ◽  
Debra L. Barton ◽  
Kelley Lynn Young ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Short Form ◽  
Performance Status ◽  
Menopausal Status ◽  
Controlled Study ◽  
Cancer Related Fatigue ◽  
Prospective Longitudinal ◽  
Over Time

10045 Background: Cancer related fatigue (CRF) is commonly reported among breast cancer survivors and can negatively impact quality of life and treatment adherence. Large, prospective, longitudinal studies assessing CRF in breast cancer survivors compared to matched non-cancer controls are rare. Methods: Breast cancer survivors (n = 581, stage I-IIIBC, mean age 53.4) from community oncology clinics and age-matched controls (n = 364, mean age 52.6) completed the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI, scores range -24 to 96) prior to chemotherapy (T1), at chemotherapy completion (T2) and six-months after chemotherapy (T3). Linear mixed models compared trajectories of CRF over time in survivors compared to controls, adjusting for age, education, race, BMI, marital status, menopausal status, and depressive symptoms. Results: Survivors reported greater CRF compared to controls at all time points (mean total score T1 9.4 vs. -3.7, T2 17.0 vs. -3.3, and T3 8.5 vs. -3.1, all p < 0.001; all subscales p < 0.001). From T1 to T2 survivors experienced a significant increase in CRF as shown in the total score (mean change (MC) = 8.3; effect size (ES) = 0.4 , p < 0.001), and general, mental, and physical sub-scales (MC = 4.3, 2.1, 3.2 , ES = 0.7, 0.5, 0.7, respectively, all p < 0.001), while controls experience minimal changes (MC = 0.1-0.3, ES < 0.09, p > 0.05). At T3 survivors total score returned to T1 values (MC = -0.1, ES = 0.01, p = 0.461), which was, however, still greater than controls ( p < 0.001), while general, mental, and physical CRF subscale scores remained significantly higher than T1 values (MC = 1.2, 1.7, 1.9, ES = 0.2, 0.4, 0.3, respectively, all p < 0.001; controls no change). Group by time interactions indicated changes over time were greater in the survivors than controls (p < 0.001). In multivariate analyses of survivors, age, BMI, performance status, and baseline depression significantly predicted change in CRF. Conclusions: These results from the largest well-controlled study to date showed that breast cancer survivors experience significantly more CRF prior to and after chemotherapy compared to healthy controls. Further research should aim to identify subgroups of survivors most susceptible to CRF.

scholarly journals Study of Chemotherapy-Induced Cognitive Impairment in Women with Breast Cancer

2020 ◽  
Vol 17 (23) ◽  
pp. 8896
Author(s):  
Blanca Rodríguez Martín ◽  
Eduardo José Fernández Rodríguez ◽  
María Isabel Rihuete Galve ◽  
Juan Jesús Cruz Hernández
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Anxiety And Depression ◽  
Oncology Patients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
The Impact

Background: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient’s quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. Method: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed—processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). Results: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. Conclusion: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.

Differential impact of endocrine therapy (ET) and chemotherapy (CT) on quality of life (QoL) of 4,262 breast cancer (BC) survivors: A prospective patient-reported outcomes (PRO) analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 512-512
Author(s):  
Arlindo R. Ferreira ◽  
Antonio Di Meglio ◽  
Barbara Pistilli ◽  
Arnauld S. Gbenou ◽  
Mayssam El-Mouhebb ◽  
...  
Keyword(s):  
Menopausal Status ◽  
Stage I ◽  
Negative Effects ◽  
Differential Impact ◽  
Prospective Longitudinal Study ◽  
Patient Reported ◽  
Linear Regression Modeling ◽  
Eortc Qlq ◽  
Prospective Longitudinal ◽  
The Impact

512 Background: We recently witnessed a trend to de-escalate CT and escalate ET in adjuvant BC treatment (tx). However, there has been limited prior research investigating the differential impact on QoL of tx classes. We aimed to test the impact of CT and ET on QoL PROs 2 yrs after diagnosis (dx). Methods: CANTO (NCT01993498) is a multicenter prospective longitudinal study of stage I-III BC pts that characterizes long-term toxicities of BC tx. For this analysis we included 4262 pts recruited from 2012-14. QoL was extensively evaluated using the EORTC QLQ C30 and BR23. Linear regression modeling was performed, adjusting for demographic and clinical factors, with use of CT and/or ET as independent variables. Analyses were stratified by menopausal status due to different tx patterns and sequelae of CT. Results: Median age at dx was 56 yrs, 63% of pts were post (PostM) and 37% premenopausal (PreM), 80% had Charlson score 0, 91% stage I-II. 26% received mastectomy, 52% CT (preM 68%, postM 44%; 86% anthracycline+taxane) and 82% ET (preM 89% tamoxifen; postM 88% aromatase inhibitor). 32% preM pts had menses 1 year after ET initiation. Overall, QoL deteriorates 2 yrs after dx. ET negatively impacts more QoL domains than CT at 2 yrs. Also, young age, smoking, income, aggressive local tx and physiological distress are often associated with low QoL. In the stratified analyses, in postM pts, mostly ET (not CT) is associated with deteriorated QoL. In contrast, in preM pts, mostly CT (not ET) is associated with deteriorated QoL. Table shows eg of associations. Conclusions: In a large prospective cohort of BC survivors, detrimental QoL 2 yrs after dx is mostly associated with ET; however, negative effects of CT persist on preM. This differential effect on QOL should be considered when choosing optimal adjuvant therapy and appropriate selection of pts for ET escalation should be a research priority. [Table: see text]

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