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Berrino F, Villarini A, Gargano G, Krogh V, Grioni S, Bellegotti M, Venturelli E, Raimondi M, Traina A, Zarcone M, Amodio R, Mano MP, Johansson H, Panico S, Santucci de Magistris M, Barbero M, Gavazza C, Mercandino A, Consolaro E, Galasso R, Del Riccio L, Bassi MC, Simeoni M, Premoli P, Pasanisi P, Bonanni B, Bruno E. The Effect of Diet on Breast Cancer Recurrence: The DIANA-5 Randomized Trial. Clin Cancer Res 2024; 30:965-974. [PMID: 37847493 PMCID: PMC10905522 DOI: 10.1158/1078-0432.ccr-23-1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/02/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE The DIANA-5 randomized controlled trial assessed the effectiveness of a diet based on Mediterranean and macrobiotic traditions (macro-Mediterranean diet) in reducing breast cancer recurrence. PATIENTS AND METHODS The DIANA-5 study involved 1,542 patients with breast cancer at high risk of recurrence because of estrogen receptor-negative cancer, or metabolic syndrome, or high plasma levels of insulin or testosterone. Women were randomly assigned to an active dietary intervention (IG) or a control group (CG). Both groups received the 2007 American Institute for Cancer Research/World Cancer Research Fund recommendations for cancer prevention. The intervention consisted of meetings with kitchen classes, community meals, and dietary recommendations. Recommended foods included whole grain cereals, legumes, soy products, vegetables, fruit, nuts, olive oil, and fish. Foods to be avoided were refined products, potatoes, sugar and desserts, red and processed meat, dairy products, and alcoholic drinks. A compliance Dietary Index was defined by the difference between recommended and discouraged foods. RESULTS Over the 5 years of follow-up, 95 patients of the IG and 98 of the CG developed breast cancer recurrence [HR = 0.99; 95% confidence interval (CI): 0.69-1.40]. The analysis by compliance to the dietary recommendations (IG and CG together) showed that the women in the upper tertile of Dietary Index change had an HR of recurrence of 0.59 (95% CI: 0.36-0.92) compared with women in the lower tertile. CONCLUSIONS The DIANA-5 dietary intervention trial failed to show a reduction in breast cancer recurrence, although self-reported diet at year 1 in IG and CG combined showed a protective association with the higher Dietary Index change. See related commentary by McTiernan, p. 931.
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Affiliation(s)
- Franco Berrino
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
- La Grande Via Foundation, Milan, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, Section of Hygiene and Public Health, University of Perugia, Perugia, Italy
| | - Giuliana Gargano
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Vittorio Krogh
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Sara Grioni
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Manuela Bellegotti
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Elisabetta Venturelli
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Milena Raimondi
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Adele Traina
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Maurizio Zarcone
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Rosalba Amodio
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Maria Piera Mano
- Dipartimento Scienze Chirurgiche, Study University, Turin, Italy
- S.C. Epidemiologia dei Tumori, AOU Città della Salute e della Scienza, CPO Piemonte, Turin, Italy
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | | | | | | | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Rionero in Vulture, Italy
| | - Luciana Del Riccio
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Rionero in Vulture, Italy
| | | | | | | | - Patrizia Pasanisi
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Eleonora Bruno
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Baldelli G, Natalucci V, Ferri Marini C, Sisti D, Annibalini G, Saltarelli R, Bocconcelli M, Gentilini V, Emili R, Rocchi MBL, Lucertini F, Barbieri E, Brandi G, De Santi M. A home-based lifestyle intervention program reduces the tumorigenic potential of triple-negative breast cancer cells. Sci Rep 2024; 14:2409. [PMID: 38287041 PMCID: PMC10824728 DOI: 10.1038/s41598-024-52065-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/12/2024] [Indexed: 01/31/2024] Open
Abstract
Translational research for the evaluation of physical activity habits and lifestyle modifications based on nutrition and exercise has recently gained attention. In this study, we evaluated the effects of serum samples obtained before and after a 12-week home-based lifestyle intervention based on nutrition and exercise in breast cancer survivors in terms of modulation of the tumorigenic potential of breast cancer cells. The home-based lifestyle intervention proposed in this work consisted of educational counselling on exercise and nutritional behaviors and in 12 weeks of structured home-based exercise. Triple-negative breast cancer cell line MDA-MB-231 was cultured in semi-solid medium (3D culture) with sera collected before (PRE) and after (POST) the lifestyle intervention program. Spheroid formation was evaluated by counting cell colonies after 3 weeks of incubation. Results show a slight but significant reduction of spheroid formation induced by serum collected POST in comparison to those obtained PRE. Moreover, statistical analyses aimed to find physiologic and metabolic parameters associated with 3D cell proliferation revealed the proliferative inducer IGF-1 as the only predictor of cell tumorigenic potential. These results highlight the importance of lifestyle changes for cancer progression control in a tertiary prevention context. Translational research could offer a useful tool to identify metabolic and physiological changes induced by exercise and nutritional behaviors associated with cancer progression and recurrence risk.
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Affiliation(s)
- Giulia Baldelli
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Valentina Natalucci
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Carlo Ferri Marini
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Davide Sisti
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Giosuè Annibalini
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Roberta Saltarelli
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Matteo Bocconcelli
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Veronica Gentilini
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Rita Emili
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029, Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Francesco Lucertini
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Elena Barbieri
- Division of Exercise and Health Sciences, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Giorgio Brandi
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Mauro De Santi
- Unit of Pharmacology and Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy
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3
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Natalucci V, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Vallorani L, Saltarelli R, Panico AR, Imperio M, Flori M, Busacca P, Villarini A, Donati Zeppa S, Agostini D, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effect of a lifestyle intervention program's on breast cancer survivors' cardiometabolic health: Two-year follow-up. Heliyon 2023; 9:e21761. [PMID: 38027927 PMCID: PMC10651516 DOI: 10.1016/j.heliyon.2023.e21761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study is to assess the cardiometabolic responses of a lifestyle intervention (LI) conducted at home among breast cancer (BC) survivors during the two years of COVID-19 pandemic. A 3-month LI focused on diet and exercise was performed on thirty BC survivors (women; stages 0-II; non-metastatic; aged 53.6 ± 7.6 years; non-physically active) with a risk factor related to metabolic/endocrine diseases. Anthropometrics, cardiorespiratory fitness (V ˙ O2max), physical activity level (PAL), adherence to the Mediterranean diet (MeDiet modified questionnaire), and several biomarkers (i.e., glycemia, insulin, insulin resistance [HOMA-IR] index, triglycerides, high- [HDL] and low- [LDL] density lipoproteins, total cholesterol, progesterone, testosterone, and hs-troponin) were evaluated before and 3-, 6-, 12-, and 24-month after the LI. Beneficial effects of the LI were observed on several variables (i.e., body mass index, waist circumference, MeDiet, PAL, V ˙ O2max, glycemia, insulin, HOMA-IR index, LDL, total cholesterol, triglycerides, testosterone) after 3-month. The significant effect on Mediterranean diet adherence and V ˙ O2max persisted up to the 24-month follow-up. Decreases in HOMA-IR index and triglycerides were observed up to 12-month, however did not persist afterward. This study provides evidence on the positive association between LI and cardiometabolic health in BC survivors.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marta Imperio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Paolo Busacca
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, University of Perugia, Piazzale Settimio Gambuli, 06132, Perugia, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Simone Barocci
- U.O.C. Patologia Clinica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | | | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132, Roma, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Rita Emili
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
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De Santi M, Annibalini G, Marano G, Biganzoli G, Venturelli E, Pellegrini M, Lucertini F, Brandi G, Biganzoli E, Barbieri E, Villarini A. Association between metabolic syndrome, insulin resistance, and IGF-1 in breast cancer survivors of DIANA-5 study. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04755-6. [PMID: 37106164 PMCID: PMC10374719 DOI: 10.1007/s00432-023-04755-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Circulating insulin-like growth factor-1 (IGF-1) is positively associated with the risk of BC recurrence, and is more frequently dysregulated in older people, especially in those with metabolic syndrome (MetS) and obesity. This study aimed to analyze the association between IGF-1 levels and indices of MetS and insulin resistance in BC survivors. METHODS Baseline data of 563 BC survivors enrolled in the DIet and ANdrogen-5 (DIANA-5; NCT05019989) study were analyzed. RESULTS Lower circulating IGF-1 levels in subjects with MetS than in those without MetS were found. After stratification of the patients according to the diagnosis of MetS, we highlighted that the insulin was the main predictor of elevated IGF-1 levels only in subjects without MetS. Moreover, we found an interaction between high-density lipoprotein cholesterol (HDL-C), glycemia, and IGF-1 levels, showing a positive correlation between HDL-C and IGF-1, especially in subjects with higher values of glycemia and without a diagnosis of MetS. CONCLUSIONS While IGF-1 levels appear to be much more impaired in subjects diagnosed with MetS, in non-MetS subjects, IGF-1 levels may respond better to metabolic parameters and lifestyle changes. Further studies are needed to analyze the role of physical activity and/or dietary intervention in modulating IGF-1 concentrations in BC survivors. IMPLICATIONS FOR CANCER SURVIVORS These results could have important clinical implications for planning customized strategies aimed at modulating IGF-1 levels in BC survivors. In fact, while the IGF-1 system seems to be much more compromised in subjects with a diagnosis of MetS, in noMetS subjects, IGF-1 levels could better respond to lifestyle changes.
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Affiliation(s)
- Mauro De Santi
- Unit of Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giuseppe Marano
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Giacomo Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Elisabetta Venturelli
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giorgio Brandi
- Unit of Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Elia Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy.
| | - Anna Villarini
- Hygiene and Public Health, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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The relationship between diet quality indices and odds of breast cancer in women: a case-control study. BMC Womens Health 2023; 23:90. [PMID: 36879242 PMCID: PMC9990286 DOI: 10.1186/s12905-023-02242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Dietary quality is an important factor in the etiology of breast cancer (BrCa), but further studies are required to better elucidate this relationship. Accordingly, we sought to analyze if diet quality, assessed using the Diet Quality Index-International (DQI-I), Mean Adequacy Ratio (MAR), and Dietary Energy Density (DED), was related to BrCa. In this Hospital-based case-control study, 253 patients with BrCa and 267 non BrCa controls were enrolled. Individual food consumption data from a food frequency questionnaire was used to calculate the Diet Quality Indices (DQI). Employing a case-control design, odds ratios (ORs) and 95% confidence intervals (CIs) were obtained, and a dose-response analysis investigated. After adjusting for potential confounders, those in the highest quartile of the MAR index had significantly lower odds of BrCa than those in the lowest (OR = 0.42, 95% CI 0.23-0.78; P for trend = 0.007). Although there was no association between individual quartiles of the DQI-I and BrCa, there was evidence of a significant trend across all the quartile categories (P for trend = 0.030).There was no significant association was found between DED index and the odds of BrCa in the crude and fully adjusted models. We found that higher MAR indices were associated with decreased odds of BrCa, Therefore, the dietary patterns reflected by these scores may serve as a possible guide to preventing BrCa in Iranian women.
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Berishvili AI, Kedrova AG, Greyan TA, Zaitseva OV. Obesity and breast cancer. TUMORS OF FEMALE REPRODUCTIVE SYSTEM 2022. [DOI: 10.17650/1994-4098-2022-18-3-40-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The paper presents an analysis of the latest literature data on the problem of obesity and breast cancer (BC). This review presents modern approaches to the diagnosis of BC in obese patients, new molecular methods of breast imaging, analyzes the features of the course of BC with obesity depending on menstrual status, molecular biological subtypes of the tumor, the mechanisms of the development of BC against the background of obesity.
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Affiliation(s)
- A. I. Berishvili
- Department of Obstetrics and Gynecology, Academy of Postgraduate Education, Federal Research and Clinical Center, Federal Biomedical Agency; Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
| | - A. G. Kedrova
- Department of Obstetrics and Gynecology, Academy of Postgraduate Education, Federal Research and Clinical Center, Federal Biomedical Agency; Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation; Institute of Oncology and Neurosurgery, E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
| | - T. A. Greyan
- Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
| | - O. V. Zaitseva
- Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation
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Islam D, Islam MS, Jesmin. Association of hypertension, hyperlipidemia, obesity, and demographic risk factors with breast cancer in Bangladeshi women. Medicine (Baltimore) 2022; 101:e31698. [PMID: 36409880 PMCID: PMC9678571 DOI: 10.1097/md.0000000000031698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
In recent years, breast cancer incidences and related deaths have been rising among Bangladeshi women and will be a major threat by 2040. So, conducting more population-based studies is crucial. This case-control study was designed to quantitatively evaluate potential risk factors for breast cancer. In this population-based case-control study, 52 random breast cancer cases and 59 matched healthy controls, aged between 25 and 70 years, were included. The breast cancer patient samples were collected from the National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh, from December 2021 to February 2022. The study was conducted fully following the Declaration of Helsinki guidelines. The collected socio-demographic data and blood samples of the study participants were analyzed. Chi-square analysis was used to compare study characteristics between cases and controls, Odds ratios (ORs) with 95% confidence intervals (CIs) were derived by univariate-logistic regression, and models were adjusted where necessary for study characteristics. Summary demographic characteristics of the 111 study participants suggested that higher age: (≥45): [OR 4.38, 95% CI (1.94-9.89), P value <.001], height: (<1.5 m): [OR 3.01, 95% CI (1.12-8.12), P value .029], low-incomes: [OR 6.83, 95% CI (2.11-22.05), P value .001], and illiteracy: [OR 12.65, 95% CI (3.49-45.79), P value .0001] showed significant correlations with breast cancer. The patient's body mass index (BMI) (≥30) indicated an association with breast cancer: [OR 3.91, 95% CI (1.00-15.31), P value .05]. The lipid profile: [triglycerides (TG): OR = 3.20, 95% CI (1.36-7.53), P value .008; TG/high-density lipid (HDL): OR = 8.82, 95% CI (2.81-27.68), P value <.001; and a lowered HDL: OR = 3.32, 95% CI (1.38-7.98), P value .007], hypertension: [systolic: OR 4.32, 95% CI (1.71-10.93), P value .002; and diastolic: OR 7.32, 95% CI (2.51-21.34), P value <.001], and gastric issues: [OR 6.07, 95% CI (2.00-18.37), P value .001], all showed significant association with breast cancer. The ER- breast cancer subtype was significantly associated with the overweight (OW) group (P value .046) whereas the PR-patients were significantly higher in the normal BMI group (P value .013). Results from this study might aid in the prevention, management, and raising of awareness against the specific risk factors among Bangladeshi women in near future.
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Affiliation(s)
- Diganta Islam
- Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Md. Shihabul Islam
- Department of Genetic Engineering & Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Jesmin
- Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka, Bangladesh
- * Correspondence: Jesmin, Department of Genetic Engineering & Biotechnology, University of Dhaka, Dhaka-1000, Bangladesh (e-mail: )
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Rubino R, Iuliucci MR, Gatani S, Piscosquito A, D’Ambrosio B, Ingenito C, Scafuri L, Buonerba C, Di Lorenzo G. Mediterranean Diet as a Supportive Intervention in Cancer Patients: Current Evidence and Future Directions. Curr Oncol 2022; 29:7579-7582. [PMID: 36290874 PMCID: PMC9600992 DOI: 10.3390/curroncol29100597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Cancer currently represents a leading cause of morbidity and mortality, and it can be held responsible for about one in six deaths worldwide [...].
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Affiliation(s)
- Roberta Rubino
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Michela Rosaria Iuliucci
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Simona Gatani
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Arianna Piscosquito
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Bruno D’Ambrosio
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Concetta Ingenito
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Luca Scafuri
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Carlo Buonerba
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
| | - Giuseppe Di Lorenzo
- Oncology Unit, “Andrea Tortora” Hospital, ASL Salerno, 84016 Pagani, Italy
- Associazione O.R.A.—Oncology Research Assistance, 80049 Somma Vesuviana, Italy
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- Correspondence: ; Tel.: +39-0819-213-111
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9
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Exercise and Cardio-Oncology Rehab. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2022. [DOI: 10.1007/s11936-022-00968-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Unmet Nutritional and Psychological Needs of Cancer Patients: An Integrated Multi-Professional Model Approach. Diseases 2022; 10:diseases10030047. [PMID: 35892741 PMCID: PMC9326516 DOI: 10.3390/diseases10030047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary This paper reports the design and exploitation of an integrated approach aimed at addressing the nutritional and psychological needs of cancer patients. In particular, patients recruited for the study undertook a path through which their nutritional and psychological status was assessed, improved and reinforced, ultimately leading to ameliorating their quality of life and, eventually, the outcome of their disease. Abstract This paper presents a multi-professional integrated approach toward the recognition and management of the nutritional and psychological needs of cancer patients. In particular, the patients undertook a multi-professional, multistep process that included the collection of both personal and clinical data, the evaluation of anthropometric measures, nutritional status and psychometric indices, and an ensuing personalized nutritional prescription and psychological support, ultimately leading to combined nutritional and psychological interventions to control their adherence to a nutritional program and to consolidate motivation to change. Overall, 120 patients were recruited for the study. The majority (84.2%) were female. Breast cancer was by far the most frequent malignancy (52.5%), followed by colorectal (17.5%), pancreatic (9.2%), ovarian (9.2%) and lung (5.0%) cancers. The results of the nutritional and psychological screening at baseline indicated that only 35% of patients had a normal BMI, whilst a relatively high proportion (nearly 32%) was overweight or obese (25%). The INRAN and MEDI-LITE questionnaires, which were used to assess the eating habits and adherence to a Mediterranean diet, respectively, revealed a mixed prevalence of cereals/cereal-based, fresh/processed meat, and fish or fishery food, with a medium–low adherence to the Mediterranean diet in nearly 38% of patients. The BUT, HADS and SF-36 tests, which were used to assess psychological disturbances, showed that 37.5% of patients had disorders regarding body image, 29.2% had abnormal anxiety and 20.0% had a depressive state, while no significant association was observed between the SF-36 PCS and MCS and the patients′ characteristics. The results of the potential impact of this novel approach on the QoL of patients after completion of the course are awaited with expectation.
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Association between novel dietary and lifestyle inflammation indices with risk of breast cancer (BrCa): a case-control study. Nutr J 2022; 21:14. [PMID: 35232437 PMCID: PMC8889766 DOI: 10.1186/s12937-022-00766-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pro-inflammatory diet and lifestyle factors lead to diseases related to chronically systemic inflammation. We examined the novel dietary/lifestyle indicators related to inflammation such dietary inflammation score (DIS), lifestyle inflammation score (LIS), empirical dietary inflammatory index (EDII) and, risk of Breast Cancer (BrCa) in Iranian woman. Methods In this hospital-based case–control study, 253 patients with BrCa and 267 non-BrCa controls were enrolled. Food consumption was recorded to calculate the DIS, LIS and EDII using a semi-quantitative Food Frequency Questionnaire (FFQ). We estimated odds ratios (ORs) and, 95% confidence intervals for the association of the inflammatory potential with risk of these cancers using binary logistic regression models modified for the case–control design. Results Mean ± SD of age and BMI of the study participants were 47.92 ± 10.33 years and 29.43 ± 5.51 kg/m2, respectively. After adjustment for confounders, individuals in highest compared to lowest quartile of DIS and EDII had significantly higher risk of BrCa (DIS: 2.13 (1.15 – 3.92), p-trends: 0.012), EDII: 2.17 (1.12 – 4.22), p-trends: 0.024). However, no significant association was observed for LIS (P-trends: 0.374). Conclusion Findings of this study suggested that higher DIS and EDI increased the risk of BrCa, but concerning LIS, further investigation is needed.
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Ly TTG, Yun J, Lee DH, Chung JS, Kwon SM. Protective Effects and Benefits of Olive Oil and Its Extracts on Women's Health. Nutrients 2021; 13:4279. [PMID: 34959830 PMCID: PMC8705829 DOI: 10.3390/nu13124279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 01/05/2023] Open
Abstract
Women and men share similar diseases; however, women have unique issues, including gynecologic diseases and diseases related to menstruation, menopause, and post menopause. In recent decades, scientists paid more attention to natural products and their derivatives because of their good tolerability and effectiveness in disease prevention and treatment. Olive oil is an essential component in the Mediterranean diet, a diet well known for its protective impact on human well-being. Investigation of the active components in olive oil, such as oleuropein and hydroxytyrosol, showed positive effects in various diseases. Their effects have been clarified in many suggested mechanisms and have shown promising results in animal and human studies, especially in breast cancer, ovarian cancer, postmenopausal osteoporosis, and other disorders. This review summarizes the current evidence of the role of olives and olive polyphenols in women's health issues and their potential implications in the treatment and prevention of health problems in women.
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Affiliation(s)
- Thanh Truong Giang Ly
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Korea; (T.T.G.L.); (J.Y.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Korea
| | - Jisoo Yun
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Korea; (T.T.G.L.); (J.Y.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Korea
| | - Dong-Hyung Lee
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;
| | - Joo-Seop Chung
- Department of Hematology-Oncology, Medical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Sang-Mo Kwon
- Laboratory for Vascular Medicine and Stem Cell Biology, Department of Physiology, Medical Research Institute, School of Medicine, Pusan National University, Yangsan 50612, Korea; (T.T.G.L.); (J.Y.)
- Convergence Stem Cell Research Center, Pusan National University, Yangsan 50612, Korea
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Pistelli M, Natalucci V, Scortichini L, Agostinelli V, Lenci E, Crocetti S, Merloni F, Bastianelli L, Taus M, Fumelli D, Giulietti G, Cola C, Capecci M, Serrani R, Ceravolo MG, Ricci M, Nicolai A, Barbieri E, Nicolai G, Ballatore Z, Savini A, Berardi R. The Impact of Lifestyle Interventions in High-Risk Early Breast Cancer Patients: A Modeling Approach from a Single Institution Experience. Cancers (Basel) 2021; 13:cancers13215539. [PMID: 34771702 PMCID: PMC8583345 DOI: 10.3390/cancers13215539] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
A healthy lifestyle plays a strategic role in the prevention of BC. The aim of our prospective study is to evaluate the effects of a lifestyle interventions program based on special exercise and nutrition education on weight, psycho-physical well-being, blood lipid and hormonal profile among BC patients who underwent primary surgery. From January 2014 to March 2017, a multidisciplinary group of oncologists, dieticians, physiatrists and an exercise specialist evaluated 98 adult BC female patients at baseline and at different time points. The patients had at least one of the following risk factors: BMI ≥ 25 kg/m2, high testosterone levels, high serum insulin levels or diagnosis of MS. Statistically significant differences are shown in terms of BMI variation with the lifestyle interventions program, as well as in waist circumference and blood glucose, insulin and testosterone levels. Moreover, a statistically significant difference was reported in variations of total Hospital Anxiety and Depression Scale (HADS) score, in the anxiety HADS score and improvement in joint pain. Our results suggested that promoting a healthy lifestyle in clinical practice reduces risk factors involved in BC recurrence and ensures psycho-physical well-being.
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Affiliation(s)
- Mirco Pistelli
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
- Correspondence: (M.P.); (R.B.); Tel.: +39-071-5964265 (M.P.); Fax: +39-071-5965053 (M.P.)
| | - Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (E.B.)
| | - Laura Scortichini
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Veronica Agostinelli
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Edoardo Lenci
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Sonia Crocetti
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Filippo Merloni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Lucia Bastianelli
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Marina Taus
- Dietology and Clinical Nutrition, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.T.); (D.F.); (G.G.); (C.C.); (A.N.)
| | - Daniele Fumelli
- Dietology and Clinical Nutrition, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.T.); (D.F.); (G.G.); (C.C.); (A.N.)
| | - Gloria Giulietti
- Dietology and Clinical Nutrition, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.T.); (D.F.); (G.G.); (C.C.); (A.N.)
| | - Claudia Cola
- Dietology and Clinical Nutrition, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.T.); (D.F.); (G.G.); (C.C.); (A.N.)
| | - Marianna Capecci
- Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.C.); (M.G.C.)
| | - Roberta Serrani
- Division of Rehabilitation Medicine, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (R.S.); (M.R.)
| | - Maria Gabriella Ceravolo
- Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.C.); (M.G.C.)
| | - Maurizio Ricci
- Division of Rehabilitation Medicine, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (R.S.); (M.R.)
| | - Albano Nicolai
- Dietology and Clinical Nutrition, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (M.T.); (D.F.); (G.G.); (C.C.); (A.N.)
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (E.B.)
| | - Giulia Nicolai
- Department of Medical Emergency, AOU Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy;
| | - Zelmira Ballatore
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Agnese Savini
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
| | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, 60126 Ancona, Italy; (L.S.); (V.A.); (E.L.); (S.C.); (F.M.); (L.B.); (Z.B.); (A.S.)
- Correspondence: (M.P.); (R.B.); Tel.: +39-071-5964265 (M.P.); Fax: +39-071-5965053 (M.P.)
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Abbasi F, Pourjalali H, do Nascimento IJB, Zargarzadeh N, Mousavi SM, Eslami R, Milajerdi A. The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis. Cytokine 2021; 149:155712. [PMID: 34644675 DOI: 10.1016/j.cyto.2021.155712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/17/2021] [Accepted: 09/13/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite several studies on the effects of exercise training on inflammatory biomarkers in patients with breast cancer, no earlier study has systematically summarized their findings. Current systematic review and meta-analysis has been done on earlier clinical trials in this topic. METHOD Relevant studies published up to August 2021 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar using predefined keywords. Studies that examined the effect of exercise training on inflammatory biomarkers in adult women with breast cancer were included. RESULT A total of 18 studies were included. Combining 11 effect sizes, exercise training significantly reduced CRP level (WMD: -0.55; 95% CI: -1.10, -0.01). However, it had no significant influence on serum TNF-α (WMD: -0.40; 95% CI: -1.30, 0.50) and IL-6 concentrations (WMD: -0.05, 95% CI: -0.53, 0.43) in 8 and 15 studies, respectively. Pooling 7 effect sizes, we failed to find significant changes in IL-8 following exercise training (WMD: -0.65, 95% CI: -1.57, 0.28). Moreover, we reached no significant findings for serum levels of INF-ɣ (WMD: -2.66, 95% CI: -7.67, 2.36), IL-1β (WMD: 0.03, 95% CI: -0.26, 0.21), and IL-10 (WMD: -0.70, 95% CI: -2.92, 1.52). Based on subgroup analyses, best findings were reached in long-term intervention and after concurrent training. DISCUSSION Chronic inflammation is hypothesized to be associated with breast cancer development. We found significant reduction in CRP level following exercise training, which was more considerable after concurrent aerobic and resistance training and in long-term intervention. No significant changes were seen in serum levels of TNF-α, IL-6, IL-8, IL-10, INF-ɣ, IL-1β following exercise training. Further studies are needed to find more details.
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Affiliation(s)
- Fatemeh Abbasi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Hanieh Pourjalali
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Israel Júnior Borges do Nascimento
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States; University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Eslami
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran.
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
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Mediterranean Diet Food Components as Possible Adjuvant Therapies to Counteract Breast and Prostate Cancer Progression to Bone Metastasis. Biomolecules 2021; 11:biom11091336. [PMID: 34572548 PMCID: PMC8470063 DOI: 10.3390/biom11091336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/16/2022] Open
Abstract
Bone metastasis is a serious and often lethal complication of particularly frequent carcinomas, such as breast and prostate cancers, which not only reduces survival but also worsens the patients’ quality of life. Therefore, it is important to find new and/or additional therapeutic possibilities that can counteract the colonization of bone tissue. High adherence to the Mediterranean diet (MD) is effective in the prevention of cancer and improves cancer patients’ health, thus, here, we considered its impact on bone metastasis. We highlighted some molecular events relevant for the development of a metastatic phenotype in cancer cells and the alterations of physiological bone remodeling, which occur during skeleton colonization. We then considered those natural compounds present in MD foods with a recognized role to inhibit or reverse the metastatic process both in in vivo and in vitro systems, and we reported the identified mechanisms of action. The knowledge of this bioactivity by the dietary components of the MD, together with its wide access to all people, could help not only to maintain healthy status but also to improve the quality of life of patients with bone metastases.
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Bruno E, Krogh V, Gargano G, Grioni S, Bellegotti M, Venturelli E, Panico S, Santucci de Magistris M, Bonanni B, Zagallo E, Mercandino A, Bassi MC, Amodio R, Zarcone M, Galasso R, Barbero M, Simeoni M, Mano MP, Berrino F, Villarini A, Pasanisi P. Adherence to Dietary Recommendations after One Year of Intervention in Breast Cancer Women: The DIANA-5 Trial. Nutrients 2021; 13:nu13092990. [PMID: 34578868 PMCID: PMC8468802 DOI: 10.3390/nu13092990] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
Abstract
The Diet and Androgen-5 (DIANA-5) trial aimed at testing whether a dietary change based on the Mediterranean diet and on macrobiotic principles can reduce the incidence of breast cancer (BC)-related events. We analyzed the adherence to the DIANA-5 dietary recommendations by randomization group after 1 year of intervention. We evaluated the association between dietary adherence and changes in body weight and metabolic syndrome (MS) parameters. BC women aged 35-70 years were eligible. After the baseline examinations, women were randomized into an intervention group (IG) or a control group (CG). A total of 1344 BC women (689 IG and 655 CG) concluded the first year of dietary intervention. IG showed greater anthropometric and metabolic improvements compared to CG. These changes were significantly associated with increased adherence to the dietary recommendations. Women who increased recommended foods consumption or reduced discouraged foods consumption showed an Odds Ratio (OR) of 1.37 (0.70-2.67) and 2.02 (1.03-3.98) to improve three or more MS parameters. Moreover, women in the higher category of dietary change showed a four times higher OR of reducing body weight compared to the lower category (p < 0.001). The DIANA-5 dietary intervention is effective in reducing body weight and MS parameters.
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Affiliation(s)
- Eleonora Bruno
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Vittorio Krogh
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Giuliana Gargano
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
- Correspondence: ; Tel.: +39-022-390-3514; Fax: +39-022-390-3516
| | - Sara Grioni
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Manuela Bellegotti
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Elisabetta Venturelli
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | | | | | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, 20141 Milano, Italy; (B.B.); (E.Z.)
| | - Emanuela Zagallo
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCCS, 20141 Milano, Italy; (B.B.); (E.Z.)
| | | | | | - Rosalba Amodio
- Clinical Epidemiology and Cancer Registry Unit, Palermo Province Cancer Registry, Palermo University Hospital P. Giaccone, 90127 Palermo, Italy; (R.A.); (M.Z.)
| | - Maurizio Zarcone
- Clinical Epidemiology and Cancer Registry Unit, Palermo Province Cancer Registry, Palermo University Hospital P. Giaccone, 90127 Palermo, Italy; (R.A.); (M.Z.)
| | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, 85028 Rionero in Vulture, Italy;
| | - Maggiorino Barbero
- Obstetrics and Gynecology Unit, Cardinal Massaia Hospital, 14100 Asti, Italy;
| | | | - Maria Piera Mano
- Dipartimento Scienze Chirurgiche, Study University, 10124 Turin, Italy;
- S.C. Epidemiologia dei Tumori, AOU Città della Salute e della Scienza, CPO Piemonte, 10126 Turin, Italy
| | - Franco Berrino
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Anna Villarini
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
| | - Patrizia Pasanisi
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (E.B.); (V.K.); (S.G.); (M.B.); (E.V.); (F.B.); (A.V.); (P.P.)
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Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study. Breast 2021; 60:6-14. [PMID: 34454324 PMCID: PMC8399332 DOI: 10.1016/j.breast.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients. METHODS This prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention. RESULTS Two hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4-8]). After the nutritional intervention (median follow-up: 22 months [range 12-45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8-13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m2 to 24.4 kg/m2, p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile. CONCLUSION This study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence.
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Rubinstein MM, Brown KA, Iyengar NM. Targeting obesity-related dysfunction in hormonally driven cancers. Br J Cancer 2021; 125:495-509. [PMID: 33911195 PMCID: PMC8368182 DOI: 10.1038/s41416-021-01393-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/05/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is a risk factor for at least 13 different types of cancer, many of which are hormonally driven, and is associated with increased cancer incidence and morbidity. Adult obesity rates are steadily increasing and a subsequent increase in cancer burden is anticipated. Obesity-related dysfunction can contribute to cancer pathogenesis and treatment resistance through various mechanisms, including those mediated by insulin, leptin, adipokine, and aromatase signalling pathways, particularly in women. Furthermore, adiposity-related changes can influence tumour vascularity and inflammation in the tumour microenvironment, which can support tumour development and growth. Trials investigating non-pharmacological approaches to target the mechanisms driving obesity-mediated cancer pathogenesis are emerging and are necessary to better appreciate the interplay between malignancy, adiposity, diet and exercise. Diet, exercise and bariatric surgery are potential strategies to reverse the cancer-promoting effects of obesity; trials of these interventions should be conducted in a scientifically rigorous manner with dose escalation and appropriate selection of tumour phenotypes and have cancer-related clinical and mechanistic endpoints. We are only beginning to understand the mechanisms by which obesity effects cell signalling and systemic factors that contribute to oncogenesis. As the rates of obesity and cancer increase, we must promote the development of non-pharmacological lifestyle trials for the treatment and prevention of malignancy.
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Affiliation(s)
- Maria M. Rubinstein
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Kristy A. Brown
- grid.5386.8000000041936877XDepartment of Biochemistry in Medicine, Weill Cornell Medical College, New York, NY USA
| | - Neil M. Iyengar
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
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19
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Natalucci V, Marini CF, Flori M, Pietropaolo F, Lucertini F, Annibalini G, Vallorani L, Sisti D, Saltarelli R, Villarini A, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown. J Clin Med 2021; 10:2678. [PMID: 34204528 PMCID: PMC8235209 DOI: 10.3390/jcm10122678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women; stages 0-II; non-metastatic; aged 53.5 ± 7.6 years; non-physically active; normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7; p = 0.035); diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2; p < 0.001); PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564; p < 0.001); VO2max (mL·min-1·kg-1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8; p < 0.001); signs of diastolic dysfunction (participants: T0 = 15, T1 = 10; p = 0.007); AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7; p = 0.032); 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542; p = 0.014); glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0; p < 0.001); insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11; p = 0.005); testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20; p = 0.003); hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74; p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesca Pietropaolo
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Anna Villarini
- Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Simone Barocci
- U.O.C. Patologia Clinica, Ospedale Santa Maria della Misericordia, Area Vasta n. 1, 61029 Urbino, Italy;
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Roma, Italy;
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Rita Emili
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
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20
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Anderson AS, Martin RM, Renehan AG, Cade J, Copson ER, Cross AJ, Grimmett C, Keaver L, King A, Riboli E, Shaw C, Saxton JM. Cancer survivorship, excess body fatness and weight-loss intervention-where are we in 2020? Br J Cancer 2021; 124:1057-1065. [PMID: 33235316 PMCID: PMC7961062 DOI: 10.1038/s41416-020-01155-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/24/2020] [Accepted: 10/22/2020] [Indexed: 01/29/2023] Open
Abstract
Earlier diagnosis and more effective treatments mean that the estimated number of cancer survivors in the United Kingdom is expected to reach 4 million by 2030. However, there is an increasing realisation that excess body fatness (EBF) is likely to influence the quality of cancer survivorship and disease-free survival. For decades, the discussion of weight management in patients with cancer has been dominated by concerns about unintentional weight loss, low body weight and interventions to increase weight, often re-enforced by the existence of the obesity paradox, which indicates that high body weight is associated with survival benefits for some types of cancer. However, observational evidence provides strong grounds for testing the hypothesis that interventions for promoting intentional loss of body fat and maintaining skeletal muscle in overweight and obese cancer survivors would bring important health benefits in terms of survival outcomes and long-term impact on treatment-related side effects. In this paper, we outline the need for studies to improve our understanding of the health benefits of weight-loss interventions, such as hypocaloric healthy-eating plans combined with physical activity. In particular, complex intervention trials that are pragmatically designed are urgently needed to develop effective, clinically practical, evidence-based strategies for reducing EBF and optimising body composition in people living with and beyond common cancers.
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Affiliation(s)
- Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Division of Population Health & Genomics, University of Dundee Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
| | - Richard M Martin
- Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- University Hospitals Bristol NHS Foundation Trust National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Andrew G Renehan
- The Christie NHS Foundation Trust, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Janet Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, G11, Stead House, University of Leeds, Leeds, LS2 9JT, UK
| | - Ellen R Copson
- Wessex Genomic Medicine Centre, Cancer Sciences Academic Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, Sligo, F91 YW50, Ireland
| | - Angela King
- NIHR Cancer and Nutrition Collaboration, Level E and Pathology Block (mailpoint 123), Southampton General Hospital, Tremona Road, Southampton, SO 16 6YD, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Clare Shaw
- Biomedical Research Centre at The Royal Marsden and the Institute of Cancer Research, Fulham Road, London, SW3 6JJ, UK
| | - John M Saxton
- Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle upon Tyne, NE1 8ST, UK
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21
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McTiernan A. Diet and Prognosis in Women with Breast Cancer. Cancer Epidemiol Biomarkers Prev 2021; 30:252-254. [PMID: 33547146 DOI: 10.1158/1055-9965.epi-20-1506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022] Open
Abstract
Women who have obesity or who have metabolic abnormalities, including diabetes, prediabetes, or hyperglycemia/insulinemia, have poorer survival compared with other women with breast cancer. Data are lacking on specific lifestyle modifications to prevent or treat these conditions to improve women's chances of survival from breast cancer. The Nurses' Health Study cohorts provide new evidence that diets with the potential to elevate circulating insulin or glucose are associated with breast cancer prognosis. The researchers found statistically significant evidence that women in the highest quintile of glycemic load had a 31% higher risk of breast cancer-specific mortality and a 26% higher risk of all-cause mortality. While a randomized controlled clinical trial testing if a reduced glycemic load diet reduces recurrence or death would be optimal, evidence from this observational study suggests that diet matters in survival from breast cancer. The dietary guidelines provided by the World Cancer Research Fund/American Institute for Cancer Research, the American Cancer Society, and the American Society for Clinical Oncology, which collectively emphasize increased intake of vegetables, fruits, whole grains, and legumes, and reduced intake of sugar, calorie-dense foods, and sugary drinks, are reasonable for most breast cancer survivors to follow for optimal health.See related article by Farvid et al., p. 335.
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Affiliation(s)
- Anne McTiernan
- Division of Public Health Sciences, Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington. .,School of Public Health, Department of Epidemiology, University of Washington, Seattle, Washington.,School of Medicine, Department of Medicine (Geriatrics), University of Washington, Seattle, Washington
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22
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Hauner D, Rack B, Friedl T, Hepp P, Janni W, Hauner H. Rationale and description of a lifestyle intervention programme to achieve moderate weight loss in women with non-metastatic breast cancer: the lifestyle intervention part of the SUCCESS C Study. BMJ Nutr Prev Health 2020; 3:213-219. [PMID: 33521531 PMCID: PMC7841841 DOI: 10.1136/bmjnph-2020-000119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 01/16/2023] Open
Abstract
Objective There is growing evidence from observational studies that lifestyle factors such as obesity, an unhealthy diet and lack of physical activity are associated with poor long-term outcome in women with breast cancer. The primary objective of the lifestyle modification part of the Simultaneous Study of Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as well as Life Style Intervention Strategies (SUCCESS C) Trial is to investigate the effect of an individualised lifestyle intervention programme aiming at moderate weight loss on disease-free survival in women with HER2/neu-negative breast cancer. Secondary objectives include the effect of the intervention on body weight, cardiovascular risk and quality of life. Methods The SUCCESS C Trial is an open-label, multicentre, randomised controlled phase III study using a 2×2 factorial design in women with newly diagnosed HER2/neu-negative intermediate-risk to high-risk breast cancer. The first randomisation served to compare disease-free survival in patients treated with two different chemotherapy regimens (3642 participants). The second randomisation served to compare disease-free survival in patients with a body mass index of 24–40 kg/m² (2292 participants) receiving either a telephone-based individualised lifestyle intervention programme for moderate weight loss or general recommendations for a healthy lifestyle for 2 years. Outcome analyses will be conducted after 5 years of follow-up. Perspective This study will provide information on the efficacy and safety of a comprehensive lifestyle intervention programme on disease-free survival in a large cohort of women with breast cancer. EU Clinical Trials Identifier: 2008-005453-38.
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Affiliation(s)
- Dagmar Hauner
- Else Kroener-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Thomas Friedl
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Philip Hepp
- Department of Gynecology and Obstetrics, University Hospital Augsburg, Augsburg, Germany.,Department of Gynecological Oncology, University Witten Herdecke Faculty of Medicine, Witten, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Hans Hauner
- Else Kroener-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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23
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Orman A, Johnson DL, Comander A, Brockton N. Breast Cancer: A Lifestyle Medicine Approach. Am J Lifestyle Med 2020; 14:483-494. [PMID: 32922233 DOI: 10.1177/1559827620913263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Breast cancer is the most common female cancer diagnosis in the United States (excluding skin cancers), and the second leading cause of female cancer death. This article highlights the role that lifestyle plays in primary breast cancer prevention, breast cancer treatment, and tertiary breast cancer prevention. Current data regarding the benefits of a predominantly plant-based diet in combination with physical activity and maintenance of a healthy body weight will be reviewed. The evidenced-based patient-focused recommendations developed by the World Cancer Research Fund/American Institute for Cancer Research will be discussed in the context of an overall lifestyle strategy. It is our hope that this publication empowers clinicians to provide patients with personalized cancer-protective lifestyle prescriptions.
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Affiliation(s)
| | | | - Amy Comander
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Nigel Brockton
- American Institute for Cancer Research, Arlington, Virginia
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24
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ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery. Surg Obes Relat Dis 2020; 16:713-724. [DOI: 10.1016/j.soard.2020.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/31/2022]
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25
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Ligibel JA, Basen-Engquist K, Bea JW. Weight Management and Physical Activity for Breast Cancer Prevention and Control. Am Soc Clin Oncol Educ Book 2019; 39:e22-e33. [PMID: 31099634 DOI: 10.1200/edbk_237423] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Observational evidence has consistently linked excess adiposity and inactivity to increased breast cancer risk and to poor outcomes in individuals diagnosed with early-stage, potentially curable breast cancer. There is less information from clinical trials testing the effect of weight management or physical activity interventions on breast cancer risk or outcomes, but a number of ongoing trials will test the impact of weight loss and other lifestyle changes after cancer diagnosis on the risk of breast cancer recurrence. Lifestyle changes have additional benefits beyond their potential to decrease primary or secondary breast cancer risk, including improvements in metabolic parameters, reduction in the risk of comorbidities such as diabetes and heart disease, improvement of physical functioning, and mitigation of side effects of cancer therapy. Despite these myriad benefits, implementation of lifestyle interventions in at-risk and survivor populations has been limited to date. This article reviews the evidence linking lifestyle factors to breast cancer risk and outcomes, discusses completed and ongoing randomized trials testing the impact of lifestyle change in primary and secondary breast cancer prevention, and reviews efforts to implement and disseminate lifestyle interventions in at-risk and breast cancer survivor populations.
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26
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Paxton RJ, Garner W, Dean LT, Logan G, Allen-Watts K. Health Behaviors and Lifestyle Interventions in African American Breast Cancer Survivors: A Review. Front Oncol 2019; 9:3. [PMID: 30723698 PMCID: PMC6349825 DOI: 10.3389/fonc.2019.00003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 01/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background: African American breast cancer survivors have a higher incidence of estrogen receptor negative and basal-like (e.g., triple negative) tumors, placing them at greater risk for poorer survival when compared to women of other racial and ethnic groups. While access to equitable care, late disease stage at diagnosis, tumor biology, and sociodemographic characteristics contribute to health disparities, poor lifestyle characteristics (i.e., inactivity, obesity, and poor diet) contribute equally to these disparities. Lifestyle interventions hold promise in shielding African American survivors from second cancers, comorbidities, and premature mortality, but they are often underrepresented in studies promoting positive behaviors. This review examined the available literature to document health behaviors and lifestyle intervention (i.e., obesity, physical activity, and sedentary behavior) studies in African American breast cancer survivors. Methods: We used PubMed, Academic Search Premier, and Scopus to identify cross-sectional and intervention studies examining the lifestyle behaviors of African American breast cancer survivors. Identified intervention studies were assessed for risk of bias. Other articles were identified and described to provide context for the review. Results: Our systematic review identified 226 relevant articles. The cross-sectional articles indicated poor adherence to physical activity and dietary intake and high rates of overweight and obesity. The 16 identified intervention studies indicated reasonable to modest study adherence rates (>70%), significant reductions in weight (range -1.9 to -3.6%), sedentary behavior (-18%), and dietary fat intake (range -13 to -33%) and improvements in fruit and vegetable intake (range +25 to +55%) and physical activity (range +13 to +544%). The risk of bias for most studies were rated as high (44%) or moderate (44%). Conclusions: The available literature suggests that African American breast cancer survivors adhere to interventions of various modalities and are capable of making modest to significant changes. Future studies should consider examining (a) mediators and moderators of lifestyle behaviors and interventions, (b) biological outcomes, and (c) determinants of enhanced survival in this population.
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Affiliation(s)
- Raheem J Paxton
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL, United States
| | - William Garner
- Department of Life and Health Sciences, University of North Texas at Dallas, Dallas, TX, United States
| | - Lorraine T Dean
- Department of Epidemiology, John Hopkins School of Public Health, Baltimore, MD, United States
| | - Georgiana Logan
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL, United States
| | - Kristen Allen-Watts
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL, United States
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Rossi E, Noberasco C, Picchi M, Stefano MD, Rossi A, Nurra L, Ventura L. Complementary and Integrative Medicine to Reduce Adverse Effects of Anticancer Therapy. J Altern Complement Med 2018; 24:933-941. [PMID: 30247968 DOI: 10.1089/acm.2018.0143] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To address the side effects of anticancer treatments, the Clinic for Complementary Medicine and Diet in Oncology was opened, in collaboration with the oncology department, at the Hospital of Lucca (Italy) in 2013. AIM To present the results of complementary medicine treatment targeted toward reducing the adverse effects of anticancer therapy and cancer symptoms, and improving patient quality of life. Dietary advice was aimed at the reduction of foods that promote inflammation in favor of those with antioxidant and anti-inflammatory properties. METHODS This is a retrospective observational study on 357 patients consecutively visited from September 2013 to December 2017. The intensity of symptoms was evaluated according to a grading system from G0 (absent) to G1 (slight), G2 (moderate), and G3 (strong). The severity of radiodermatitis was evaluated with the Radiation Therapy Oncology Group (RTOG) scale. Almost all the patients (91.6%) were receiving or had just finished some form of conventional anticancer therapy. RESULTS The main types of cancer were breast (57.1%), colon (7.3%), lung (5.0%), ovary (3.9%), stomach (2.5%), prostate (2.2%), and uterus (2.5%). Comparison of clinical conditions before and after treatment showed a significant amelioration of nausea, insomnia, depression, anxiety, fatigue, mucositis, hot flashes, joint pain, dysgeusia, neuropathy, and all symptoms. Moreover, in a subgroup of 17 patients in radiotherapy undergoing integrative treatment, the level of toxicities and the severity of radiodermatitis were much lower than in the 13 patients without integrative treatment. Twenty-one cancer patients (6.2%) either refused (18) or discontinued (3) conventional anticancer treatment against the recommendation of their oncologist; after the integrative oncology (IO) visit, 7 (41.2%) out of 17 patients with follow-up decided to accept standard oncologic treatments. CONCLUSIONS An IO clinic may contribute to reducing the adverse effects of anticancer therapy and improving the quality of life of cancer patients.
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Affiliation(s)
- Elio Rossi
- 1 Center for Complementary Medicine , ASL Tuscany North West, Lucca, Italy
| | - Cristina Noberasco
- 1 Center for Complementary Medicine , ASL Tuscany North West, Lucca, Italy
| | - Marco Picchi
- 1 Center for Complementary Medicine , ASL Tuscany North West, Lucca, Italy
| | | | - Antonella Rossi
- 1 Center for Complementary Medicine , ASL Tuscany North West, Lucca, Italy
| | - Linda Nurra
- 1 Center for Complementary Medicine , ASL Tuscany North West, Lucca, Italy
| | - Leonardo Ventura
- 2 ISPRO, Oncological Network, Prevention and Research Institute , Firenze, Italy
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28
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Ligibel JA. Is It Time to Give Breast Cancer Patients a Prescription for a Low-Fat Diet? JNCI Cancer Spectr 2018; 2:pky066. [PMID: 31360881 PMCID: PMC6649733 DOI: 10.1093/jncics/pky066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/22/2018] [Indexed: 11/27/2022] Open
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30
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Mutschler NS, Scholz C, Friedl TW, Zwingers T, Fasching PA, Beckmann MW, Fehm T, Mohrmann S, Salmen J, Ziegler C, Jäger B, Widschwendter P, de Gregorio N, Schochter F, Mahner S, Harbeck N, Weissenbacher T, Jückstock J, Janni W, Rack B. Prognostic Impact of Weight Change During Adjuvant Chemotherapy in Patients With High-Risk Early Breast Cancer: Results From the ADEBAR Study. Clin Breast Cancer 2018; 18:175-183. [DOI: 10.1016/j.clbc.2018.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/23/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
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Abstract
Weight, weight change and physical activity may affect prognosis among women who are diagnosed with breast cancer. Observational studies show associations between overweight/obesity and weight gain with several measures of reduced prognosis in women with breast cancer, and some suggestions of lower survival in women who are underweight or who experience unexplained weight loss after diagnosis. Observational studies have also shown an association between higher levels of physical activity and reduced breast cancer-specific and all-cause mortality, although a dose–response relationship has not been established. The effects of purposive dietary weight loss and increase in physical activity on survival or recurrence in breast cancer are not yet established, and randomised controlled trials are needed for definitive data. This paper presents the epidemiologic evidence on weight status, weight change, and physical activity and breast cancer survival; suggests potential mediating mechanisms; summarises evidence on weight loss interventions in breast cancer survivors; describes ongoing randomised clinical trials designed to test the effects of weight loss or physical activity on breast cancer survival; and provides information on available guidelines on weight and physical activity for cancer survivors.
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Demark-Wahnefried W, Schmitz KH, Alfano CM, Bail JR, Goodwin PJ, Thomson CA, Bradley DW, Courneya KS, Befort CA, Denlinger CS, Ligibel JA, Dietz WH, Stolley MR, Irwin ML, Bamman MM, Apovian CM, Pinto BM, Wolin KY, Ballard RM, Dannenberg AJ, Eakin EG, Longjohn MM, Raffa SD, Adams-Campbell LL, Buzaglo JS, Nass SJ, Massetti GM, Balogh EP, Kraft ES, Parekh AK, Sanghavi DM, Morris GS, Basen-Engquist K. Weight management and physical activity throughout the cancer care continuum. CA Cancer J Clin 2018; 68:64-89. [PMID: 29165798 PMCID: PMC5766382 DOI: 10.3322/caac.21441] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/20/2022] Open
Abstract
Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, "Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum." Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89. © 2017 American Cancer Society.
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Affiliation(s)
| | - Kathryn H Schmitz
- Professor of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Catherine M Alfano
- Vice President, Survivorship, American Cancer Society, Inc., Washington, DC
| | - Jennifer R Bail
- Post-Doctoral Fellow, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Pamela J Goodwin
- Professor of Medicine, Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute at the University of Toronto, Toronto, Ontario, Canada
| | - Cynthia A Thomson
- Professor of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Don W Bradley
- Associate Consulting Professor, Community and Family Medicine, Duke School of Medicine, Durham, NC
| | - Kerry S Courneya
- Professor of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christie A Befort
- Associate Professor of Preventive Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Crystal S Denlinger
- Associate Professor of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | - William H Dietz
- Chair, Redstone Global Center for Prevention and Wellness, George Washington University, Washington, DC
| | | | - Melinda L Irwin
- Professor of Epidemiology, Yale School of Public Health, New Haven, CT
| | - Marcas M Bamman
- Professor of Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Rachel M Ballard
- Director, Prevention Research Coordination, Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD
| | | | - Elizabeth G Eakin
- Professor and Director, Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Matt M Longjohn
- Vice President and National Health Officer, YMCA of the USA, Chicago, IL
| | - Susan D Raffa
- National Program Director for Weight Management, Veterans Health Administration, Durham, NC
| | | | - Joanne S Buzaglo
- Senior Vice President, Research and Training Institute, Cancer Support Community, Philadelphia, PA
| | - Sharyl J Nass
- Director, National Cancer Policy Forum and Board on Health Care Services, Health and Medicine Division, National Academies of Science, Engineering, and Medicine, Washington, DC
| | - Greta M Massetti
- Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Erin P Balogh
- Senior Program Officer, National Cancer Policy Forum, Health and Medicine Division, National Academies of Science, Engineering, and Medicine, Washington, DC
| | | | - Anand K Parekh
- Chief Medical Advisor, Bipartisan Policy Center, Washington, DC
| | - Darshak M Sanghavi
- Chief Medical Officer, Senior Vice President, Translation, Optum Labs, Cambridge, MA
| | | | - Karen Basen-Engquist
- Professor of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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Abstract
Diet, physical activity, and body weight have been shown to play an important role in cancer survivorship. The impact of each of these lifestyle factors differs slightly among cancer types, and adherence to recommended diet and physical activity guidelines has been associated with positive outcomes, including decrease in the risk of cancer recurrence and improvement of quality of life. Although there are compelling data that appropriate diet, physical activity, and body weight have beneficial effects in cancer survivorship, additional trials are needed to understand the relationship.
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Affiliation(s)
- Karishma Mehra
- Department of Medical Oncology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Alyssa Berkowitz
- Department of Medical Oncology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Tara Sanft
- Department of Medical Oncology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
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Lee DH, Jacobs DR, Park HY, Carpenter DO. A role of low dose chemical mixtures in adipose tissue in carcinogenesis. ENVIRONMENT INTERNATIONAL 2017; 108:170-175. [PMID: 28863389 DOI: 10.1016/j.envint.2017.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 05/15/2023]
Abstract
The Halifax project recently hypothesized a composite carcinogenic potential of the mixture of low dose chemicals which are commonly encountered environmentally, yet which are not classified as human carcinogens. A long neglected but important fact is that adipose tissue is an important exposure source for chemical mixtures. In fact, findings from human studies based on several persistent organic pollutants in general populations with only background exposure should be interpreted from the viewpoint of chemical mixtures because serum concentrations of these chemicals can be seen as surrogates for chemical mixtures in adipose tissue. Furthermore, in conditions such as obesity with dysfunctional adipocytes or weight loss in which lipolysis is increased, the amount of the chemical mixture released from adipose tissue to circulation is increased. Thus, both obesity and weight loss can enhance the chance of chemical mixtures reaching critical organs, however paradoxical this idea may be when fat mass is the only factor considered. The complicated, interrelated dynamics of adipocytes and chemical mixtures can explain puzzling findings related to body weight among cancer patients, including the obesity paradox. The contamination of fat in human diet with chemical mixtures, occurring for reasons similar to contamination of human adipose tissue, may be a missing factor which affects the association between dietary fat intake and cancer. The presence of chemical mixtures in adipose tissue should be considered in future cancer research, including clinical trials on weight management among cancer survivors.
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Affiliation(s)
- Duk-Hee Lee
- Department of Preventative Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Republic of Korea.
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ho Yong Park
- Department of Breast and Thyroid Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - David O Carpenter
- Center for the Elimination of Minority Health Disparities, University at Albany, Albany, NY, United States; Institute for Health and the Environment, University at Albany, Rensselaer, NY, United States
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Graham ÉA, Mallet JF, Jambi M, Nishioka H, Homma K, Matar C. MicroRNA signature in the chemoprevention of functionally-enriched stem and progenitor pools (FESPP) by Active Hexose Correlated Compound (AHCC). Cancer Biol Ther 2017; 18:765-774. [PMID: 28886271 PMCID: PMC5678688 DOI: 10.1080/15384047.2017.1373211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/25/2017] [Accepted: 08/24/2017] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Many breast cancer patients use natural compounds in their battle against breast cancer. Active Hexose Correlated Compound (AHCC®) is a cultured mushroom mycelium extract shown to favorably modulate the immune system and alleviate cancer burden. Cancer Stem cells (CSCs) are a subset of highly tumorigenic cancer cells that are thought to be responsible for recurrence. CSCs can be epigenetically regulated by microRNAs (miRNAs). We hypothesized that AHCC may influence CSCs by modulating tumor-suppressor or oncogenic miRNAs. METHODS Functionally-enriched stem and progenitor pools (FESPP) were isolated in the form of mammospheres from MDA-MB-231, MCF-7, and 4T1 cells, exposed to AHCC in both regular and primary culture from Balb/c mice, and analyzed by visual counting and flow cytometry. Cell motility was also observed in MDA-MB-231 cells. Profiling and RT-qPCR were performed to determine AHCC influence on miRNAs in MDA-MB-231 mammospheres. Additionally, Balb/c mice were orally gavaged with AHCC, and tumor growth parameters and miR-335 expression were analyzed. MDA-MB-231 cells were transfected with miR-335 and analyzed by western blot. RESULTS We demonstrated that AHCC reduced mammosphere growth in three cell lines and in primary culture, prevented cell migration, and upregulated miR-335 expression in MDA-MB-231 cells and mouse tumor samples. Among the differentially regulated miRNAs in CSCs, we focused on tumor suppressor miR-335, known to target extracellular matrix protein Tenascin C (TNC). TNC is involved in CSC immune evasion pathways. In MDA-MB-231, inhibition of miR-335 increased TNC protein expression. CONCLUSIONS These results support that AHCC limits FESPP growth, partly by targeting miRNA pathways.
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Affiliation(s)
- Émilie A. Graham
- Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
| | - Jean-François Mallet
- Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Majed Jambi
- Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kohei Homma
- R&D Division Amino Up Chemical Co, Ltd, Sapporo, Japan
| | - Chantal Matar
- Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
- Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Picon‐Ruiz M, Morata‐Tarifa C, Valle‐Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA Cancer J Clin 2017; 67:378-397. [PMID: 28763097 PMCID: PMC5591063 DOI: 10.3322/caac.21405] [Citation(s) in RCA: 477] [Impact Index Per Article: 68.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 02/06/2023] Open
Abstract
Answer questions and earn CME/CNE Recent decades have seen an unprecedented rise in obesity, and the health impact thereof is increasingly evident. In 2014, worldwide, more than 1.9 billion adults were overweight (body mass index [BMI], 25-29.9 kg/m2 ), and of these, over 600 million were obese (BMI ≥30 kg/m2 ). Although the association between obesity and the risk of diabetes and coronary artery disease is widely known, the impact of obesity on cancer incidence, morbidity, and mortality is not fully appreciated. Obesity is associated both with a higher risk of developing breast cancer, particularly in postmenopausal women, and with worse disease outcome for women of all ages. The first part of this review summarizes the relationships between obesity and breast cancer development and outcomes in premenopausal and postmenopausal women and in those with hormone receptor-positive and -negative disease. The second part of this review addresses hypothesized molecular mechanistic insights that may underlie the effects of obesity to increase local and circulating proinflammatory cytokines, promote tumor angiogenesis and stimulate the most malignant cancer stem cell population to drive cancer growth, invasion, and metastasis. Finally, a review of observational studies demonstrates that increased physical activity is associated with lower breast cancer risk and better outcomes. The effects of recent lifestyle interventions to decrease sex steroids, insulin/insulin-like growth factor-1 pathway activation, and inflammatory biomarkers associated with worse breast cancer outcomes in obesity also are discussed. Although many observational studies indicate that exercise with weight loss is associated with improved breast cancer outcome, further prospective studies are needed to determine whether weight reduction will lead to improved patient outcomes. It is hoped that several ongoing lifestyle intervention trials, which are reviewed herein, will support the systematic incorporation of weight loss intervention strategies into care for patients with breast cancer. CA Cancer J Clin 2017;67:378-397. © 2017 American Cancer Society.
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Affiliation(s)
- Manuel Picon‐Ruiz
- Postdoctoral Associate, Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL
| | - Cynthia Morata‐Tarifa
- Postdoctoral Associate, Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL
| | | | - Eitan R. Friedman
- Resident in Internal Medicine, Department of MedicineUniversity of MiamiMiamiFL
| | - Joyce M. Slingerland
- Director, Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL
- Professor, Division of Medical Oncology, Department of MedicineDivision of Hematology Oncology, University of MiamiMiamiFL
- Professor, Department of Biochemistry and Molecular BiologyUniversity of Miami Miller School of MedicineMiamiFL.
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37
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Epidemiology and biology of physical activity and cancer recurrence. J Mol Med (Berl) 2017; 95:1029-1041. [PMID: 28620703 PMCID: PMC5613065 DOI: 10.1007/s00109-017-1558-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/24/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022]
Abstract
Physical activity is emerging from epidemiologic research as a lifestyle factor that may improve survival from colorectal, breast, and prostate cancers. However, there is considerably less evidence relating physical activity to cancer recurrence and the biologic mechanisms underlying this association remain unclear. Cancer patients are surviving longer than ever before, and fear of cancer recurrence is an important concern. Herein, we provide an overview of the current epidemiologic evidence relating physical activity to cancer recurrence. We review the biologic mechanisms most commonly researched in the context of physical activity and cancer outcomes, and, using the example of colorectal cancer, we explore hypothesized mechanisms through which physical activity might intervene in the colorectal recurrence pathway. Our review highlights the importance of considering pre-diagnosis and post-diagnosis activity, as well as cancer stage and timing of recurrence, in epidemiologic studies. In addition, more epidemiologic research is needed with cancer recurrence as a consistently defined outcome studied separately from survival. Future mechanistic research using randomized controlled trials, specifically those demonstrating the exercise responsiveness of hypothesized mechanisms in early stages of carcinogenesis, are needed to inform recommendations about when to exercise and to anticipate additive or synergistic effects with other preventive behaviors or treatments.
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38
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Mazzoni AS, Nordin K, Berntsen S, Demmelmaier I, Igelström H. Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study. BMC Sports Sci Med Rehabil 2017; 9:8. [PMID: 28373907 PMCID: PMC5376284 DOI: 10.1186/s13102-017-0072-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/03/2017] [Indexed: 12/29/2022]
Abstract
Background Increasing physical activity (PA) and decreasing sedentary time (ST) have important health effects among breast cancer patients, a growing population group. PA and sedentary behaviors are complex multi-dimensional behaviors and are challenging to monitor accurately. To date few studies have compared self-reports and objective measurement in assessing PA and ST in women undergoing breast cancer treatments. The aim of the present study was to compare self-reports and objective measures for assessing daily time spent in moderate-intensity physical activity (MPA), vigorous-intensity physical activity (VPA) and ST in women undergoing breast cancer treatments. Methods Baseline data from 65 women with breast cancer scheduled to undergo adjuvant treatment was included. Daily time spent in MPA, VPA and ST was assessed by a study-specific logbook and the SenseWear Armband mini (SWA). The level of agreement between the two measurement methods was then determined by performing Bland-Altman plots with limits of agreements, and calculating Spearman’s rank correlation coefficients. Results The mean difference between the logbook and SWA with limits of agreement was 14 (±102) minutes for MPA, 1 (±21) minute for VPA and −196 (±408) minutes for ST, respectively. The logbook reported an average of 34 and 50% higher values than the SWA for MPA and VPA, as well as an average of 27% lower values for ST (P < 0.05). The Spearman’s rank correlation coefficients showed that the differences between the methods increased as the average amount of time spent in PA and ST increased (P < 0.01). Conclusions The results imply that the two measurement methods have limited agreement and cannot be used interchangeably.
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Affiliation(s)
- Anne-Sophie Mazzoni
- Department of Public Health and Caring Sciences, Section of lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, BMC, Uppsala, S-75122 Sweden
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Section of lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, BMC, Uppsala, S-75122 Sweden.,Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Box 422, Kristiansand, NO-4604 Norway
| | - Sveinung Berntsen
- Department of Public Health and Caring Sciences, Section of lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, BMC, Uppsala, S-75122 Sweden.,Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Box 422, Kristiansand, NO-4604 Norway
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Section of lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, BMC, Uppsala, S-75122 Sweden
| | - Helena Igelström
- Department of Public Health and Caring Sciences, Section of lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, BMC, Uppsala, S-75122 Sweden
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Jackson SE, Heinrich M, Beeken RJ, Wardle J. Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review. PLoS One 2017; 12:e0169173. [PMID: 28060948 PMCID: PMC5218508 DOI: 10.1371/journal.pone.0169173] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/13/2016] [Indexed: 12/17/2022] Open
Abstract
Background Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors. Methods We systematically searched PubMed and EMBASE for articles reporting associations between weight loss and mortality (cancer-specific or all-cause) in overweight/obese patients with obesity-related cancers. Where available, data from the same studies on non-overweight patients were compared. Results Five articles describing observational studies in breast cancer survivors were included. Four studies reported a positive association between weight loss and mortality in overweight/obese survivors, and the remaining study observed no significant association. Results were similar for non-overweight survivors. Quality assessment indicated high risk of bias across studies. Conclusions There is currently a lack of observational evidence that weight loss improves survival for overweight and obese cancer survivors. However, the potential for bias in these studies is considerable and the results likely reflect the consequences of disease-related rather than intentional weight loss. There is a need for stronger study designs, incorporating measures of intentionality of weight loss, and extended to other cancers.
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Affiliation(s)
- Sarah E. Jackson
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- * E-mail:
| | - Malgorzata Heinrich
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Rebecca J. Beeken
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Jane Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
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40
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Lifestyle and Breast Cancer. Breast Cancer 2017. [DOI: 10.1007/978-3-319-48848-6_72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cespedes Feliciano EM, Kroenke CH, Bradshaw PT, Chen WY, Prado CM, Weltzien EK, Castillo AL, Caan BJ. Postdiagnosis Weight Change and Survival Following a Diagnosis of Early-Stage Breast Cancer. Cancer Epidemiol Biomarkers Prev 2017; 26:44-50. [PMID: 27566419 PMCID: PMC5224999 DOI: 10.1158/1055-9965.epi-16-0150] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/26/2016] [Accepted: 05/04/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Achieving a healthy weight is recommended for all breast cancer survivors. Previous research on postdiagnosis weight change and mortality had conflicting results. METHODS We examined whether change in body weight in the 18 months following diagnosis is associated with overall and breast cancer-specific mortality in a cohort of n = 12,590 stage I-III breast cancer patients at Kaiser Permanente using multivariable-adjusted Cox regression models. Follow-up was from the date of the postdiagnosis weight at 18 months until death or June 2015 [median follow-up (range): 3 (0-9) years]. We divided follow-up into earlier (18-54 months) and later (>54 months) postdiagnosis periods. RESULTS Mean (SD) age-at-diagnosis was 59 (11) years. A total of 980 women died, 503 from breast cancer. Most women maintained weight within 5% of diagnosis body weight; weight loss and gain were equally common at 19% each. Compared with weight maintenance, large losses (≥10%) were associated with worse survival, with HRs and 95% confidence intervals (CI) for all-cause death of 2.63 (2.12-3.26) earlier and 1.60 (1.14-2.25) later in follow-up. Modest losses (>5%-<10%) were associated with worse survival earlier [1.39 (1.11-1.74)] but not later in follow-up [0.77 (0.54-1.11)]. Weight gain was not related to survival. Results were similar for breast cancer-specific death. CONCLUSION Large postdiagnosis weight loss is associated with worse survival in both earlier and later postdiagnosis periods, independent of treatment and prognostic factors. IMPACT Weight loss and gain are equally common after breast cancer, and weight loss is a consistent marker of mortality risk. Cancer Epidemiol Biomarkers Prev; 26(1); 44-50. ©2016 AACR SEE ALL THE ARTICLES IN THIS CEBP FOCUS SECTION, "THE OBESITY PARADOX IN CANCER EVIDENCE AND NEW DIRECTIONS".
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Affiliation(s)
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Patrick T Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Wendy Y Chen
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Erin K Weltzien
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Adrienne L Castillo
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
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Bruno E, Roveda E, Vitale J, Montaruli A, Berrino F, Villarini A, Venturelli E, Gargano G, Galasso L, Caumo A, Carandente F, Pasanisi P. Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women. Eur J Cancer Care (Engl) 2016; 27:e12617. [DOI: 10.1111/ecc.12617] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 12/20/2022]
Affiliation(s)
- E. Bruno
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Roveda
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - J. Vitale
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - A. Montaruli
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - F. Berrino
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - A. Villarini
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Venturelli
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - G. Gargano
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - L. Galasso
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - A. Caumo
- Research Centre of Metabolism; IRCCS Policlinico San Donato Milanese; Milan Italy
| | - F. Carandente
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - P. Pasanisi
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
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43
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Chlebowski RT, Reeves MM. Weight Loss Randomized Intervention Trials in Female Cancer Survivors. J Clin Oncol 2016; 34:4238-4248. [PMID: 27903147 DOI: 10.1200/jco.2016.69.4026] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose Observational study evidence has associated overweight/obesity with decreased survival in women with breast cancer and with several other cancers. Although full-scale, definitive weight loss adjuvant intervention trials with cancer end points remain to be conducted, a number of randomized controlled trials have evaluated weight loss interventions in survivors of cancer in women. Findings from these trials in breast, endometrial, and ovarian cancer are reviewed. Methods A systematic review of randomized controlled clinical trials evaluating weight loss interventions was updated (for studies published 2013 to 2016), and clinical trials registers were searched for ongoing trials. Results Six new randomized trials in breast cancer survivors and two randomized trials in endometrial cancer survivors were identified. Evidence from these trials and the 10 earlier randomized trials in female cancer survivors provide support for the feasibility of recruiting women closer to the cancer diagnosis and efficacy for achieving weight loss, in particular with telephone-based interventions, and have identified the challenge of achieving significant weight loss in African American cancer survivors and of maintaining weight loss in any cancer survivor group. Seven ongoing randomized trials are evaluating the influence of weight loss interventions on cancer end points (five in breast cancer, one in ovarian cancer, and one in endometrial cancer). Conclusion After a decade of preliminary studies, ongoing randomized, controlled clinical trials will potentially provide definitive assessment of whether weight loss can improve breast cancer clinical outcome. Longer-term interventions (> 2 years' duration) may be needed to optimize weight loss maintenance and any potential benefits on cancer end points.
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Affiliation(s)
- Rowan T Chlebowski
- Rowan T. Chlebowski, Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Marina M. Reeves, The University of Queensland, Brisbane, Queensland, Australia
| | - Marina M Reeves
- Rowan T. Chlebowski, Harbor-University of California, Los Angeles Medical Center, Torrance, CA; and Marina M. Reeves, The University of Queensland, Brisbane, Queensland, Australia
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Jiralerspong S, Goodwin PJ. Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities. J Clin Oncol 2016; 34:4203-4216. [PMID: 27903149 DOI: 10.1200/jco.2016.68.4480] [Citation(s) in RCA: 240] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose To summarize the evidence of an association between obesity and breast cancer prognosis. Methods We reviewed the literature regarding overweight and obesity and breast cancer survival outcomes, overall and with regard to breast cancer subtypes, breast cancer therapies, biologic mechanisms, and possible interventions. We summarize our findings and provide clinical management recommendations. Results Obesity is associated with a 35% to 40% increased risk of breast cancer recurrence and death and therefore poorer survival outcomes. This is most clearly established for estrogen receptor-positive breast cancer, with the relationship in triple-negative and human epidermal growth factor receptor 2-positive subtypes less well established. A range of biologic mechanisms that may underlie this association has been identified. Weight loss and lifestyle interventions, as well as metformin and other obesity-targeted therapies, are promising avenues that require further study. Conclusion Obesity is associated with inferior survival in breast cancer. Understanding the nature and mechanisms of this effect provides an important opportunity for interventions to improve the diagnosis, treatment, and outcomes of obese patients with breast cancer.
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Affiliation(s)
- Sao Jiralerspong
- Sao Jiralerspong, Baylor College of Medicine, Houston, TX; and Pamela J. Goodwin, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Pamela J Goodwin
- Sao Jiralerspong, Baylor College of Medicine, Houston, TX; and Pamela J. Goodwin, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
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Braakhuis AJ, Campion P, Bishop KS. Reducing Breast Cancer Recurrence: The Role of Dietary Polyphenolics. Nutrients 2016; 8:E547. [PMID: 27608040 PMCID: PMC5037532 DOI: 10.3390/nu8090547] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/26/2016] [Accepted: 08/31/2016] [Indexed: 12/31/2022] Open
Abstract
Evidence from numerous observational and clinical studies suggest that polyphenolic phytochemicals such as phenolic acids in olive oil, flavonols in tea, chocolate and grapes, and isoflavones in soy products reduce the risk of breast cancer. A dietary food pattern naturally rich in polyphenols is the Mediterranean diet and evidence suggests those of Mediterranean descent have a lower breast cancer incidence. Whilst dietary polyphenols have been the subject of breast cancer risk-reduction, this review will focus on the clinical effects of polyphenols on reducing recurrence. Overall, we recommend breast cancer patients consume a diet naturally high in flavonol polyphenols including tea, vegetables (onion, broccoli), and fruit (apples, citrus). At least five servings of vegetables and fruit daily appear protective. Moderate soy protein consumption (5-10 g daily) and the Mediterranean dietary pattern show the most promise for breast cancer patients. In this review, we present an overview of clinical trials on supplementary polyphenols of dietary patterns rich in polyphenols on breast cancer recurrence, mechanistic data, and novel delivery systems currently being researched.
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Affiliation(s)
- Andrea J Braakhuis
- Discipline of Nutrition and Dietetics, FM & HS, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Peta Campion
- Discipline of Nutrition and Dietetics, FM & HS, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Karen S Bishop
- Auckland Cancer Society Research Center, FM & HS, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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Dieli-Conwright CM, Lee K, Kiwata JL. Reducing the Risk of Breast Cancer Recurrence: an Evaluation of the Effects and Mechanisms of Diet and Exercise. CURRENT BREAST CANCER REPORTS 2016; 8:139-150. [PMID: 27909546 PMCID: PMC5112289 DOI: 10.1007/s12609-016-0218-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
With recent medical advances in diagnosis and treatment, the increasing numbers of long-term survivors of breast cancer is considerable and has resulted in the expansion of scientific research to include examination of lifestyle modifications as means of prevention of recurrence, new breast cancer events, and mortality. The objective of this report is to review randomized controlled trials (RCTs) including diet and/or exercise interventions on breast cancer recurrence in women with a history of breast cancer as well as pertinent recent epidemiologic evidence. Implicated biologic mechanisms are discussed to elucidate the impact of diet and exercise on disease recurrence.
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Affiliation(s)
- Christina M Dieli-Conwright
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St., CHP-155, Los Angeles, CA 90033 USA
| | - Kyuwan Lee
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St., CHP-155, Los Angeles, CA 90033 USA
| | - Jacqueline L Kiwata
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St., CHP-155, Los Angeles, CA 90033 USA
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Giallauria F, Vitelli A, Maresca L, Santucci De Magistris M, Chiodini P, Mattiello A, Gentile M, Mancini M, Grieco A, Russo A, Lucci R, Torella G, Berrino F, Panico S, Vigorito C. Exercise training improves cardiopulmonary and endothelial function in women with breast cancer: findings from the Diana-5 dietary intervention study. Intern Emerg Med 2016; 11:183-9. [PMID: 26016834 DOI: 10.1007/s11739-015-1259-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/12/2015] [Indexed: 12/18/2022]
Abstract
To investigate whether exercise training (ET) improves cardiopulmonary and endothelial function in women with breast cancer (BC). Fifty-one female patients (aged between 39 and 72 years) with a history of primary invasive BC within the previous 5 years and enrolled in the Mediterranean diet-based DIANA (diet and androgens)-5 Trial were subdivided into 2 groups: an ET group (n = 25) followed a formal ET program of moderate intensity (3 session/week on a bicycle at 60-70 % VO2peak for 3 months, followed by one session/week until 1-year follow-up), while a control group (n = 26) did not perform any formal ET. At baseline and at 1-year follow-up, all patients underwent cardiopulmonary exercise stress test (CPET) and measurements of vascular endothelial function by peripheral artery tonometry (Reactive Hyperemia Index, RHI). There were no significant differences between the groups in baseline anthropometrical, BC characteristics, and metabolic profile. No differences in baseline CPET and RHI parameters were found. Peak oxygen consumption (VO2peak) significantly increased in ET group (from 12.4 ± 2.9 to 14.3 ± 3.3 mL/kg/min, p < 0.001) compared to the control group (from 12.8 ± 2.5 to 12.6 ± 2.8 mL/kg/min, p = 0.55; p < 0.001 between groups). Compared to the control group (from 2.0 ± 0.4 to 1.9 ± 0.4, p = 0.62), the ET group showed a significant improvement of RHI after 1 year (from 2.1 ± 0.7 to 2.5 ± 0.8, p < 0.001). Changes in VO2peak were correlated with changes in RHI (ΔVO2peak vs. ΔRHI: r = 0.47, p = 0.017). In BC survivors, ET program improves cardiopulmonary functional capacity and vascular endothelial function after 12 months. Whether these changes may favorably modulate some of the pathophysiological mechanisms implied in cancer evolution should be investigated.
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Affiliation(s)
- Francesco Giallauria
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
| | - Alessandra Vitelli
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Luigi Maresca
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | | | - Paolo Chiodini
- Medical Statistics Unit, Second University of Naples, Naples, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Marco Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Maria Mancini
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Alessandra Grieco
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Angelo Russo
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Rosa Lucci
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Giorgio Torella
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Franco Berrino
- Department of Preventive and Predictive Medicine, National Cancer Institute, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Carlo Vigorito
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
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Demark-Wahnefried W, Nix JW, Hunter GR, Rais-Bahrami S, Desmond RA, Chacko B, Morrow CD, Azrad M, Frugé AD, Tsuruta Y, Ptacek T, Tully SA, Segal R, Grizzle WE. Feasibility outcomes of a presurgical randomized controlled trial exploring the impact of caloric restriction and increased physical activity versus a wait-list control on tumor characteristics and circulating biomarkers in men electing prostatectomy for prostate cancer. BMC Cancer 2016; 16:61. [PMID: 26850040 PMCID: PMC4743419 DOI: 10.1186/s12885-016-2075-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 01/19/2016] [Indexed: 01/10/2023] Open
Abstract
Background Obesity is associated with tumor aggressiveness and disease-specific mortality for more than 15 defined malignancies, including prostate cancer. Preclinical studies suggest that weight loss from caloric restriction and increased physical activity may suppress hormonal, energy-sensing, and inflammatory factors that drive neoplastic progression; however, exact mechanisms are yet to be determined, and experiments in humans are limited. Methods We conducted a randomized controlled trial among 40 overweight or obese, newly-diagnosed prostate cancer patients who elected prostatectomy to explore feasibility of a presurgical weight loss intervention that promoted a weight loss of roughly one kg. week−1 via caloric restriction and physical activity, as well as to assess effects on tumor biology and circulating biomarkers. Measures of feasibility (accrual, retention, adherence, and safety) were primary endpoints. Exploratory aims were directed at the intervention’s effect on tumor proliferation (Ki-67) and other tumor markers (activated caspase-3, insulin and androgen receptors, VEGF, TNFβ, NFκB, and 4E-BP1), circulating biomarkers (PSA, insulin, glucose, VEGF, TNFβ, leptin, SHBG, and testosterone), lymphocytic gene expression of corresponding factors and cellular bioenergetics in neutrophils, and effects on the gut microbiome. Consenting patients were randomized in a 1:1 ratio to either: 1) weight loss via a healthful, guidelines-based diet and exercise regimen; or 2) a wait-list control. While biological testing is currently ongoing, this paper details our methods and feasibility outcomes. Results The accrual target was met after screening 101 cases (enrollment rate: 39.6 %). Other outcomes included a retention rate of 85 %, excellent adherence (95 %), and no serious reported adverse events. No significant differences by age, race, or weight status were noted between enrollees vs. non-enrollees. The most common reasons for non-participation were “too busy” (30 %), medical exclusions (21 %), and “distance” (16 %). Conclusions Presurgical trials offer a means to study the impact of diet and exercise interventions directly on tumor tissue, and other host factors that are feasible and safe, though modifications are needed to conduct trials within an abbreviated period of time and via distance medicine-based approaches. Pre-surgical trials are critical to elucidate the impact of lifestyle interventions on specific mechanisms that mediate carcinogenesis and which can be used subsequently as therapeutic targets. Trial registration NCT01886677
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Affiliation(s)
- Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), 346 Webb Nutrition Sciences Bldg., 1675 University Blvd, Birmingham, AL, USA.
| | | | - Gary R Hunter
- Department of Human Studies, UAB, Birmingham, AL, USA
| | | | | | - Balu Chacko
- Department of Molecular & Cellular Pathology, UAB, Birmingham, AL, USA
| | - Casey D Morrow
- Department of Cell, Developmental & Integrative Biology, UAB, Birmingham, AL, USA
| | - Maria Azrad
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), 346 Webb Nutrition Sciences Bldg., 1675 University Blvd, Birmingham, AL, USA
| | - Andrew D Frugé
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), 346 Webb Nutrition Sciences Bldg., 1675 University Blvd, Birmingham, AL, USA
| | - Yuko Tsuruta
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), 346 Webb Nutrition Sciences Bldg., 1675 University Blvd, Birmingham, AL, USA
| | - Travis Ptacek
- Department of Microbiology, UAB, Birmingham, AL, USA
| | | | - Roanne Segal
- Department of Medicine, University of Ottawa, Ontario, Canada
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Vuong T, Mallet JF, Ouzounova M, Rahbar S, Hernandez-Vargas H, Herceg Z, Matar C. Role of a polyphenol-enriched preparation on chemoprevention of mammary carcinoma through cancer stem cells and inflammatory pathways modulation. J Transl Med 2016; 14:13. [PMID: 26762586 PMCID: PMC4712588 DOI: 10.1186/s12967-016-0770-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Naturally occurring polyphenolic compounds from fruits, particularly from blueberries, have been reported to be significantly involved in cancer chemoprevention and chemotherapy. Biotransformation of blueberry juice by Serratia vaccinii increases its polyphenolic content and endows it with anti-inflammatory properties. METHODS This study evaluated the effect of a polyphenol-enriched blueberry preparation (PEBP) and its non-fermented counterpart (NBJ), on mammary cancer stem cell (CSC) development in in vitro, in vivo and ex vivo settings. Effects of PEBP on cell proliferation, mobility, invasion, and mammosphere formation were measured in vitro in three cell lines: murine 4T1 and human MCF7 and MDA-MB-231. Ex vivo mammosphere formation, tumor growth and metastasis observations were carried out in a BALB/c mouse model. RESULTS Our research revealed that PEBP influence cellular signaling cascades of breast CSCs, regulating the activity of transcription factors and, consequently, inhibiting tumor growth in vivo by decreasing metastasis and controlling PI3K/AKT, MAPK/ERK, and STAT3 pathways, central nodes in CSC inflammatory signaling. PEBP significantly inhibited cell proliferation of 4T1, MCF-7 and MDA-MB-231. In all cell lines, PEBP reduced mammosphere formation, cell mobility and cell migration. In vivo, PEBP significantly reduced tumor development, inhibited the formation of ex vivo mammospheres, and significantly reduced lung metastasis. CONCLUSIONS This study showed that polyphenol enrichment of a blueberry preparation by fermentation increases its chemopreventive potential by protecting mice against tumor development, inhibiting the formation of cancer stem cells and reducing lung metastasis. Thus, PEBP may represent a novel complementary alternative medicine therapy and a source for novel therapeutic agents against breast cancer.
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Affiliation(s)
- Tri Vuong
- Nutritional Sciences Program, Faculty of Health Sciences, University of Ottawa, R2057 Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Jean-François Mallet
- Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Maria Ouzounova
- Cancer Center, Georgia Regents University, Augusta, GA, USA.
| | - Sam Rahbar
- Nutritional Sciences Program, Faculty of Health Sciences, University of Ottawa, R2057 Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | | | - Zdenko Herceg
- International Agency for Research on Cancer, Lyon, France.
| | - Chantal Matar
- Nutritional Sciences Program, Faculty of Health Sciences, University of Ottawa, R2057 Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
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50
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Courneya KS, Segal RJ, McKenzie DC, Dong H, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Crawford JJ, Mackey JR. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Med Sci Sports Exerc 2015; 46:1744-51. [PMID: 24633595 DOI: 10.1249/mss.0000000000000297] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
UNLABELLED Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START). METHODS The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored. RESULTS After a median follow-up of 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (CI), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% CI, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% CI, 0.32-1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% CI, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% CI, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% CI, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% CI, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19-1.15), and ≥85% of their planned chemotherapy (HR, 0.50; 95% CI, 0.25-1.01). CONCLUSIONS This exploratory follow-up of the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted.
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Affiliation(s)
- Kerry S Courneya
- 1Faculty of Physical Education, University of Alberta, Edmonton, Alberta, CANADA; 2Ottawa Hospital Regional Cancer Center, Ottawa, Ontario, CANADA; 3School of Kinesiology, University of British Columbia, Vancouver, British Columbia, CANADA; 4British Columbia Cancer Agency, Vancouver, British Columbia, CANADA; 5Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, CANADA; 6University of Ottawa Heart Institute, Ottawa, Ontario, CANADA; and 7Cross Cancer Institute, Edmonton, Alberta, CANADA
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