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Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors

  • Epidemiology
  • Published:
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Abstract

Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.

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Acknowledgments

The HEAL study was supported by National Cancer Institute Grants: N01-CN-75036-20, N01-CN-05228, and N01-PC-67010. Portions of this work were conducted through the Clinical Research Laboratory at University of Washington, supported by the National Institutes of Health Grant M01-RR-00037, or through the University of New Mexico Grant NCRR M01-RR-0997.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA

    Ikuyo Imayama, Marian L. Neuhouser, Ching-Yun Wang, Catherine Duggan & Anne McTiernan

  2. Office of Cancer Survivorship, National Cancer Institute/National Institutes of Health, Bethesda, USA

    Catherine M. Alfano

  3. Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA

    Marian L. Neuhouser & Anne McTiernan

  4. Applied Research Program, National Cancer Institute/National Institutes of Health, Bethesda, USA

    Stephanie M. George & Rachel Ballard-Barbash

  5. Outcomes Research Branch, National Cancer Institute/National Institutes of Health, Bethesda, USA

    Ashley Wilder Smith

  6. Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, USA

    Richard N. Baumgartner & Kathy B. Baumgartner

  7. Division of Cancer Etiology, Department of Population Science, Beckman Research Institute of the City of Hope, Duarte, USA

    Leslie Bernstein

  8. Department of Biostatistics, School of Public Health, University of Washington, Seattle, USA

    Ching-Yun Wang

  9. Department of Medicine, School of Medicine, University of Washington, Seattle, USA

    Anne McTiernan

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  1. Ikuyo Imayama
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Correspondence to Anne McTiernan.

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Imayama, I., Alfano, C.M., Neuhouser, M.L. et al. Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors. Breast Cancer Res Treat 140, 159–176 (2013). https://doi.org/10.1007/s10549-013-2594-y

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