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Chen Y, Xu M, Ye Q, Xiang J, Xue T, Yang T, Liu L, Yan B. Irregular delay of adjuvant chemotherapy correlated with poor outcome in stage II-III colorectal cancer. BMC Cancer 2022; 22:670. [PMID: 35715761 PMCID: PMC9206266 DOI: 10.1186/s12885-022-09767-y] [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: 03/17/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS Adjuvant chemotherapy (ACT) plays an important role in improving the survival of stage II-III colorectal cancer (CRC) patients after curative surgery. However, the prognostic role of irregular delay of ACT (IDacT) for these patients has been less studied. MATERIALS AND METHODS A total of 117 stage II-III CRC patients who underwent radical resection and received at least 3 months ACT were enrolled retrospectively. The significance of IDacT, including total delay (TD) and delay per cycle (DpC), in predicting disease-free survival (DFS) was determined using receiver operating characteristic curve (ROC) analysis. The survival differences between the TD, DpC-short and DpC-long subgroups were tested using Kaplan-Meier analysis, and risk factors for prognosis were determined using a Cox proportional hazards model. RESULTS Using 35.50 and 3.27 days as the optimal cut-off points for TD and DpC, respectively, ROC analysis revealed that TD and DpC had sensitivities of 43.60% and 59.00% and specificities of 83.30% and 62.80%, respectively, in predicting DFS (both P < 0.05). No differences in the clinicopathological parameters were found between the TD, DpC-short or -long subgroups except histological differentiation in different TD subgroups and combined T stages in different DpC subgroups (both P = 0.04). Patients in the TD or DpC-long group exhibited significantly worse survival than in the -short group (TD: Log rank = 9.11, P < 0.01; DpC: Log rank = 6.09, P = 0.01). DpC was an independent risk factor for prognosis (HR = 2.54, 95% CI: 1.32-4.88, P = 0.01). CONCLUSIONS IDacT had a profound effect on the outcome for stage II-III CRC. Although TD and DpC were significant for the prognosis, DpC was more robust, and patients who presented DpC for a long time had a significantly worse DFS.
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Affiliation(s)
- Yuanyuan Chen
- Department of General Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya City, Hainan, P.R. China
| | - Mingyue Xu
- Department of General Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya City, Hainan, P.R. China
| | - Qianwen Ye
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, No. 80 of Jianglin Road, Haitang District, Sanya City, Hainan province, 572000, P.R. China
| | - Jia Xiang
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, No. 80 of Jianglin Road, Haitang District, Sanya City, Hainan province, 572000, P.R. China
| | - Tianhui Xue
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, No. 80 of Jianglin Road, Haitang District, Sanya City, Hainan province, 572000, P.R. China
| | - Tao Yang
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, No. 80 of Jianglin Road, Haitang District, Sanya City, Hainan province, 572000, P.R. China
| | - Long Liu
- Department Traditional Chinese Medicine, Tianyou Hospital of Tongji University, No. 528 of Zhennan Road, Putuo District, Shanghai, 200331, P.R. China.
| | - Bing Yan
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, No. 80 of Jianglin Road, Haitang District, Sanya City, Hainan province, 572000, P.R. China.
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Juan Z, Qing Z, Yongping L, Qian L, Wu W, Wen Y, Tong J, Ding B. Probiotics for the Treatment of Docetaxel-Related Weight Gain of Breast Cancer Patients-A Single-Center, Randomized, Double-Blind, and Placebo-Controlled Trial. Front Nutr 2021; 8:762929. [PMID: 34926547 PMCID: PMC8675585 DOI: 10.3389/fnut.2021.762929] [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: 09/15/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Docetaxel is an important chemotherapy-agent for breast cancer treatment. One of its side-effects is weight gain, which increases the all-cause mortality rate. Considering gut microbiota is one important factor for weight regulation, we hypothesized that probiotics could be potentially used to reduce the docetaxel-related weight gain in breast cancer patients. Methods: From 10/8/2018 to 10/17/2019, 100 breast cancer (Stage I-III) patients underwent four cycles of docetaxel-based chemotherapy were enrolled and randomly assigned to receive probiotics (Bifidobacterium longum, Lactobacillus acidophilus, and Enterococcus faecalis) or placebo (supplementary material of the probiotics capsule) treatment for 84 days with three capsules per time, twice/day. The primary outcome: the changes in body weight and body-fat percentage of the patients were measured by a designated physician using a fat analyzer, and the secondary outcomes: the fasting insulin, plasma glucose, and lipids were directly obtained from the Hospital Information System (HIS); The metabolites were measured using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS); The fecal microbiome was analyzed using bacterial 16S ribosomal RNA (rRNA) gene sequence. All indicators were measured 1 day before the first cycle of docetaxel-based chemotherapy and 21 days after the last cycle of docetaxel-based chemotherapy. Results: Compared with the placebo group, the probiotic group showed significantly smaller changes in body weight (Mean [SD] 0.77 [2.58] vs. 2.70 [3.08], P = 0.03), body-fat percentage (Mean [SD] 0.04 [1.14] vs. 3.86 [11.09], P = 0.02), and low density lipoprotein (LDL) (Mean [SD]-0.05[0.68] vs. 0.39 [0.58], P = 0.002). Moreover, five of the 340 detected plasma metabolites showed significant differences between the two groups. The change of biliverdin dihydrochloride (B = -0.724, P = 0.02) was inverse correlated with weight gain. One strain of the phylum and three strains of the genus were detected to be significantly different between the two groups. Also, the changes of Bacteroides (B = -0.917, P < 0.001) and Anaerostipes (B = -0.894, P < 0.001) were inverse correlated with the change of LDL. Conclusions: Probiotics supplement during docetaxel-based chemotherapy for breast cancer treatment may help to reduce the increase in body weight, body-fat percentage, plasma LDL, and minimize the metabolic changes and gut dysbacteriosis. Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=24294, ChiCTR-INQ-17014181.
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Affiliation(s)
- Zhang Juan
- Department of Breast Surgery, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Zhang Qing
- Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Liang Yongping
- Department of Medical Imaging (Ultrasound), Tangshan Central Hospital, Tangshan, China
| | - Liyuan Qian
- Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei Wu
- Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yanguang Wen
- Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianbin Tong
- Hunan Province Key Laboratory of Brain Homeostasis, Third Xiangya Hospital, Central South University, Changsha, China
- Center for Experimental Medicine, Third Xiangya Hospital, Central South University, Changsha, China
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Boni Ding
- Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
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Bell KE, Pfeiffer AG, Schmidt S, Bos L, Russell C, Barnes T, Di Sebastiano KM, Avrutin E, Gibson M, Dubin JA, Mourtzakis M. Low-frequency exercise training improves cardiovascular fitness and strength during treatment for breast cancer: a single-arm intervention study. Sci Rep 2021; 11:22758. [PMID: 34815445 PMCID: PMC8610997 DOI: 10.1038/s41598-021-01962-4] [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: 07/12/2021] [Accepted: 10/26/2021] [Indexed: 11/09/2022] Open
Abstract
Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, however treatment-specific barriers may inhibit adherence. We explored the effect of lower-frequency exercise training on fitness, body composition, and metabolic markers (i.e. glucose and lipids) in a group of recently diagnosed breast cancer patients. Fifty-two females ≥ 18 years with stage I-IIIB breast cancer were instructed to attend 2 cardiovascular and strength training sessions/week over 12 weeks, but program length was expanded as needed to accommodate missed sessions. Pre- and post-intervention, we measured: (1) cardiovascular fitness, (2) isometric strength, (3) body composition (dual-energy X-ray absorptiometry), and (4) fasting glucose, insulin, c-peptide, and lipids. Pre-intervention, participants were 53 ± 10 years old (mean ± SD) and overweight (BMI: 27.5 ± 5.4 kg m-2, 40.1 ± 6.5% body fat). Forty participants completed the program over a median 20 weeks (range: 13-32 weeks, median frequency: 1.2 sessions/week), over which predicted VO2peak improved by 7% (2.2[0.1-4.4] mL/kg/min) (delta[95% CI]), and strength increased by 7-9% (right arm: 2.3[0.1-4.5] N m; right leg: 7.9[2.1-13.7] N m; left leg: 7.8[1.9-13.7] N m). Body composition and metabolic markers were unchanged. An exercise frequency of 1.2 sessions/week stimulated significant improvements in fitness, and may represent a practical target for patients during active treatment.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Amanda G Pfeiffer
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Schuyler Schmidt
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Lisa Bos
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Caryl Russell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Tyler Barnes
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Katie M Di Sebastiano
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Egor Avrutin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Marielle Gibson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Joel A Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
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Gomes SL, Bobby Z, Ganesan P, Saroja K, Parameswari G R. Metabolic syndrome and its related biochemical derangements in breast cancer patients who received neoadjuvant chemotherapy: A study from a tertiary care oncology centre from Puducherry, South India. Diabetes Metab Syndr 2021; 15:975-980. [PMID: 33962149 DOI: 10.1016/j.dsx.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Comparison of the existence of metabolic syndrome, its components and their related biochemical complications between newly diagnosed and treated breast cancer patients. METHODS Forty newly diagnosed untreated breast cancer patients and forty breast cancer patients who had received 7 cycles of neoadjuvant chemotherapy were recruited as group 1 and group 2 respectively. Height, weight, blood pressure, hormonal status, and tumor size were noted. The fasting blood glucose and lipid profile were estimated in AU 5811 Beckman coulter Clinical chemistry analyzer. Fasting insulin was estimated using Beckman Coulter access immunoassay system (UnicelDxI600). HbA1c assay was carried out in HPLC based ion exchange chromatography (Tosoh automated glycohemoglobin analyzer G8. Homeostasis Model Assessment 2-IR (HOMA 2-IR), HOMA-% B and HOMA-% S were calculated using an online calculator HOMA CALCULATOR [Oxford University]. Serum hsCRP and MDA were estimated by ELISA. FRAP assay was carried out manually to measure antioxidant status. RESULTS The existence of metabolic syndrome as well as type 2 diabetes was higher in the treated group when compared to the untreated patients. However, there were no significant differences in the indices of glucose homeostasis, low grade inflammation, oxidative stress and individual components of metabolic syndrome between the two groups. The triple negative patients were more prone to develop metabolic syndrome when compared to the triple positive patients. CONCLUSION Suitable therapeutic approaches may be planned out to address the metabolic syndrome and its related complications among breast cancer patients especially during the course of treatment.
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Inglis JE, Kleckner AS, Lin PJ, Gilmore NJ, Culakova E, VanderWoude AC, Mustian KM, Fernandez ID, Dunne RF, Deutsch J, Peppone LJ. Excess Body Weight and Cancer-Related Fatigue, Systemic Inflammation, and Serum Lipids in Breast Cancer Survivors. Nutr Cancer 2020; 73:1676-1686. [PMID: 32812824 DOI: 10.1080/01635581.2020.1807574] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common side effect impacting breast cancer survivors. Research points to a relationship between obesity and CRF in breast cancer survivors related to elevated systemic inflammation and metabolic alterations. METHODS This cross-sectional study examined the relationship of obesity to CRF, inflammatory markers and serum lipids through a secondary analysis of a nationwide randomized controlled trial. Breast cancer survivors with CRF were categorized based on BMI category. Symptoms of CRF, inflammatory markers and serum fatty acids were assessed among groups. RESULTS There were 105 breast cancer survivors in the analysis. BMI was positively associated with CRF based on MFSI General (p = 0.020; 95% C.I. 0.024, 0.273) and MFSI Physical (p = 0.013; 95% C.I. 0.035, 0.298) subscales. TNF-α (p = 0.007; 95% C.I. 0.007, 0.044), and IL-6 (p = 0.020; 95% C.I. 0.006, 0.073) were elevated in the obese. Monounsaturated fatty acid levels (p = 0.047; 95% C.I. 0.000, 0.053) and the omega-6 to omega-3 fatty acid ratio were associated with obesity (p = 0.047; 95% C.I. 0.002, 0.322). CONCLUSIONS Obese breast cancer survivors had greater levels of CRF, inflammatory markers and certain fatty acids. Inflammatory markers and fatty acids were not found to have any mediating or positive association with CRF variables in this analysis. NCT02352779.
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Affiliation(s)
- Julia E Inglis
- Department of Public and Community Health, Liberty University, Lynchburg, VA, USA
| | - Amber S Kleckner
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | - Po-Ju Lin
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | - Nikesha J Gilmore
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | | | - Karen M Mustian
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | - I Diana Fernandez
- Department of Public Health Sciences, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | - Richard F Dunne
- Department of Medicine, University of Rochester Medical Center (URMC), Rochester, NY, USA
| | | | - Luke J Peppone
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY, USA
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Effectiveness of a Global Multidisciplinary Supportive and Educational Intervention in Thermal Resort on Anthropometric and Biological Parameters, and the Disease-Free Survival after Breast Cancer Treatment Completion (PACThe). JOURNAL OF ONCOLOGY 2020; 2020:4181850. [PMID: 32454823 PMCID: PMC7222596 DOI: 10.1155/2020/4181850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/06/2019] [Accepted: 02/07/2020] [Indexed: 11/18/2022]
Abstract
A growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion “PACThe,” we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the “PACThe” study (n = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention “SPA” receiving a 2-week session of physical training, dietary education, and physiotherapy (n = 57), and the control “CTR” (n = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25–30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose (p < 10−6), insulin (p < 10−7), and adiponectin (p < 0.022) plasma levels for both intervention arms, which were more accentuated for the >30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI–95%] = 5.06 [1.66–15.41]; p=0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient's initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient's recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities.
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van den Berg MMGA, Kok DE, Visser M, de Vries JHM, de Kruif JTCM, de Vries Y, Posthuma L, Sommeijer DW, Timmer-Bonte A, Los M, van Laarhoven HWM, Kampman E, Winkels RM. Changes in body composition during and after adjuvant or neo-adjuvant chemotherapy in women with breast cancer stage I-IIIB compared with changes over a similar timeframe in women without cancer. Support Care Cancer 2019; 28:1685-1693. [PMID: 31290019 PMCID: PMC7036066 DOI: 10.1007/s00520-019-04951-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
Purpose Body weight and body composition may change during and after adjuvant or neo-adjuvant chemotherapy for breast cancer. However, most studies did not include a comparison group of women without cancer, thus could not assess whether observed changes differed from age-related fluctuations in body weight and body composition over time. We assessed changes in body composition during and after chemotherapy in breast cancer patients compared with age-matched women not diagnosed with cancer. Methods We recruited 181 patients with stage I–IIIb breast cancer and 180 women without cancer. In patients, we assessed body composition using a dual-energy X-ray scan before start of chemotherapy (T1), shortly after chemotherapy (T2), and 6 months after chemotherapy (T3); for the comparison group, the corresponding time points were recruitment (T1) and 6 (T2) and 12 (T3) months. Results Fifteen percent of patients and 8% of the comparison group gained at least 5% in body weight between T1 and T3. Among the comparison group, no statistically significant changes in body weight, or body composition were observed over time. Body weight of patients significantly increased from baseline (72.1 kg ± 0.4 kg) to T2 (73.3 kg ± 0.4 kg), but decreased to 73.0 kg ± 0.4 kg after chemotherapy (T3). Lean mass of patients significantly increased from 43.1 kg ± 0.5 kg at baseline to 44.0 kg ± 0.5 kg at T2, but returned to 43.1 kg ± 0.5 kg at T3. There were no differential changes in fat mass over time between patients and the comparison group. Conclusions Changes in body weight and body composition during and after chemotherapy for early stage breast cancer were modest, and did not differ substantially from changes in body weight and body composition among women without cancer.
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Affiliation(s)
- M M G A van den Berg
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - D E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - M Visser
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - J H M de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - J Th C M de Kruif
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Y de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - L Posthuma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - D W Sommeijer
- Flevoziekenhuis, Almere, the Netherlands.,Academisch Medisch Centrum, Amsterdam, the Netherlands
| | | | - M Los
- St Antonius Ziekenhuis, Nieuwegein, the Netherlands
| | | | - E Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands. .,Department of Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA. .,Wageningen University & Research, Wageningen, Netherlands.
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Buch K, Gunmalm V, Andersson M, Schwarz P, Brøns C. Effect of chemotherapy and aromatase inhibitors in the adjuvant treatment of breast cancer on glucose and insulin metabolism-A systematic review. Cancer Med 2018; 8:238-245. [PMID: 30561133 PMCID: PMC6346263 DOI: 10.1002/cam4.1911] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Breast cancer (BC) is the most common cancer among women worldwide. With increasing survival rates, focus has expanded to long-term adverse effects of adjuvant chemotherapy and/or aromatase inhibitors. Weight gain during chemotherapy has been well documented, but the underlying mechanisms remain unclear. A change in glucose and insulin metabolism is a possible consequence. METHODS We searched PubMed on the 4th of May 2018, and found eight articles that compared measurements of glucose and insulin before and after chemotherapy and/or aromatase inhibitors in woman with BC. RESULTS A general trend of increased glucose and insulin is seen and likely to be caused by weight gain and/or changes in body composition as a consequence of adjuvant treatment of BC. DISCUSSION Due to methodological limitations including short follow-up times and small sample sizes, further studies are required to better describe metabolic consequences of adjuvant chemotherapy and/or aromatase inhibitors. Future studies could help identify patients in high-risk of developing cardiometabolic disease after BC treatment.
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Affiliation(s)
- Kristian Buch
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
| | - Victoria Gunmalm
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
| | | | - Peter Schwarz
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark.,Faculty of Health Sciences, Copenhagen University, København N, Denmark
| | - Charlotte Brøns
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
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