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The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry

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Abstract

Purpose

This study assessed differences in neuropathic symptoms between colorectal cancer (CRC) patients with and without diabetes. Moreover, we aimed to explore whether neuropathic symptoms could be explained by the receipt of chemotherapy as it was previously shown that cancer patients with diabetes less often receive chemotherapy.

Methods

Data from a cross-sectional study among CRC patients (2–11 years after diagnosis) was used. Data were collected by the Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES) registry which is linked to clinical data from the population-based Eindhoven Cancer Registry. Diabetes status was self-reported and neuropathic symptoms were measured with the European Organization for Research and Treatment of Cancer quality of life questionnaire–chemotherapy-induced peripheral neuropathy 20 (EORTC QLQ-CIPN20).

Results

Two hundred eighteen CRC patients with diabetes were matched on age and sex to 975 CRC patients without diabetes. After adjustments for cancer treatment including chemotherapy and other covariates, logistic regression models showed that CRC patients with diabetes experienced more mild to severe neuropathic symptoms, including tingling fingers or hands (odds ratio (OR) = 1.40; 95 % confidence interval (CI) 1.00–1.94), tingling toes or feet (OR = 1.47; 95 % CI 1.04–2.07), numbness in toes or feet (OR = 1.83; 95 % CI 1.28–2.62), and erection problems among men (OR = 1.83; 95 % CI 1.11–3.03) as compared to CRC patients without diabetes. No differences in cancer treatment were found between CRC patients with and without diabetes.

Conclusion

CRC patients with diabetes experienced more neuropathic symptoms, regardless of cancer treatment, suggesting that diabetes itself rather than treatment with chemotherapy results in more neuropathic symptoms among cancer patients with diabetes compared to those without.

Implications for Cancer Survivors

Up to 39 % of cancer survivors might expect mainly mild, neuropathic symptoms, with more symptoms among patients with co-occurring diabetes.

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Acknowledgments

We thank all patients and their doctors for their participation in the study. Special thanks are to Dr. M van Bommel for her availability as an independent advisor and willingness to answer patients’ queries. In addition, we thank the following hospitals for their co-operation: Amphia Hospital (Breda), Bernhoven Hospital (Veghel and Oss), Catharina Hospital (Eindhoven), Elkerliek Hospital (Helmond), Jeroen Bosch Hospital (‘s-Hertogenbosch), Maxima Medical Center (Eindhoven and Veldhoven), St. Anna Hospital (Geldrop), St. Elisabeth Hospital (Tilburg), Twee Steden Hospital (Tilburg and Waalwijk), and VieCuri Hospital (Venlo and Venray).

Conflict of interest

The authors declare that there is no duality of interest associated with this manuscript.

Funding

The present research is supported in part by an investment grant [#480-08-009] of the Netherlands Organization for Scientific Research (The Hague, The Netherlands). Dr. Melissa Thong is supported by a Social Psychology Fellowship from the Dutch Cancer Society [#UVT2011-4960]. Dr. Floortje Mols is supported by a VENI grant (#451-10-041) from the Netherlands Organization for Scientific Research (The Hague, Netherlands). The funding sources were involved neither in the collection, interpretation, and analysis of the data nor in the decision for the writing and submission of this report for publication.

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Authors and Affiliations

  1. CoRPS – Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, Netherlands

    Pauline A. J. Vissers, Floortje Mols, Melissa S. Y. Thong, Frans Pouwer & Lonneke V. van de Poll-Franse

  2. Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, Eindhoven, Netherlands

    Pauline A. J. Vissers, Floortje Mols, Melissa S. Y. Thong & Lonneke V. van de Poll-Franse

  3. Department of Medical Oncology, Maastricht University Medical Center, Maastricht, Netherlands

    Gerard Vreugdenhil

  4. Department of Internal Medicine, Máxima Medical Center, Veldhoven, Netherlands

    Gerard Vreugdenhil

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  1. Pauline A. J. Vissers
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  2. Floortje Mols
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  3. Melissa S. Y. Thong
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  5. Gerard Vreugdenhil
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  6. Lonneke V. van de Poll-Franse
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Correspondence to Pauline A. J. Vissers.

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Vissers, P.A.J., Mols, F., Thong, M.S.Y. et al. The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry. J Cancer Surviv 9, 523–531 (2015). https://doi.org/10.1007/s11764-015-0429-z

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  • DOI: https://doi.org/10.1007/s11764-015-0429-z

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