Weight changes during chemotherapy for breast cancer
Keywords:
Breast Neoplasm, Chemotherapy adjuvant, Body weight, ObesityAbstract
CONTEXT: Patients receiving adjuvant chemotherapy for breast cancer have a tendency to gain weight. This tendency has determining factors not completely defined and an unknown prognostic impact. OBJECTIVE: To evaluate weight change during chemotherapy for breast cancer in a defined population and to identify its predisposing factors and possible prognostic significance. DESIGN: Observational, retrospective cohort study. SETTING: Private clinical oncology service. PARTICIPANTS: 106 consecutive patients with breast cancer treated between June 1994 and April 2000, who received neoadjuvant (n = 8), adjuvant (n = 74) or palliative (n = 24) chemotherapy. INTERVENTION: Review of medical records and gathering of clinical information, including patients’ body weights before treatment and at follow-up reviews. MAIN MEASUREMENTS: Body weight change, expressed as percentage of body weight per month in treatment; role of clinical data in weight change; and influence of weight change in overall survival and disease-free survival. RESULTS: There was a mean increase of 0.50 ± 1.42% (p = 0.21) of body weight per month of treatment. We noted a negative correlation between metastatic disease and weight gain (r = -0.447, p < 0.0001). In the adjuvant and neoadjuvant therapy groups there was a mean weight gain of 0.91 ± 1.19 % (p < 0.00001) per month, whereas in the metastatic (palliative) group, we observed a mean loss of 0.52 ± 1.21% (p = 0.11) of body weight per month during the treatment. We did not observe any statistically significant correlation between weight changes and disease-free survival or overall survival. CONCLUSIONS: Women with breast cancer undergoing adjuvant or neoadjuvant chemotherapy gain weight, whereas metastatic cancer patients will probably lose weight during palliative chemotherapy. Further studies are needed in order to evaluate the prognostic significance of weight changes during chemotherapy.
Downloads
References
Camoriano JK, Loprinzi CL, Ingle JN, Therneau TM, Krook JE, Veeder MH. Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol 1990;8:1327-34.
Bonadonna G, Valagussa P. Systemic therapy in resectable breast cancer. Hematol Oncol Clin North Am 1989;3:727-42.
Goodwin PA, Panzarella T, Boyd NF. Weight gain in women with localized breast cancer - a descriptive study. Breast Cancer Res Treat 1988;11:59-66.
Heasman KZ, Sutherland HJ, Campbell JA, Elhakim T, Boyd NF. Weight gain during adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat 1985;5:195-200.
Subramian VP, Raich PC, Walker BK. Weight gain in breast cancer patients undergoing chemotherapy. Breast Cancer Res Treat 1981;1:170 (abstr).
Knobf MK, Mullen JC, Xistris D, Moritz DA. Weight gain in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum 1983;10:28-33.
Goodwin PJ, Ennis M, Pritchard KI, et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 1999;17:120-9.
Huntington MO. Weight gain in patients receiving adjuvant chemotherapy for carcinoma of the breast. Cancer 1985;56:472-4.
Mukhopadhyay MG, Larkin S. Weight gain in cancer patients on chemotherapy. Proc Am Soc Clin Oncol 1986;5:254 (abstr 992).
Brewin TB. Can a tumor cause the same appetite perversion or taste change as a pregnancy? Lancet 1980;2:907-8.
Meyerowitz BE, Sparks FC, Spears IK. Adjuvant chemotherapy for breast carcinoma: psychosocial implications. Cancer 1979;43:1613-8.
Silberfarb PM, Maurer LH, Crouthamel CS. Psychological aspects of neoplastic disease: I. Functional status of breast cancer patients during different treatment regimens. Am J Psychiatry 1980;137:450-5.
Demark-Wahnefried W, Peterson BL, Winer EP, et al. Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 2001;19:2381-9.
den Besten C, Vansant G, Weststrate JA, Deurenberg P. Resting metabolic rate and diet-induced thermogenesis in abdominal and gluteal-femoral obese women before and after weight reduction. Am J Clin Nutr 1988;47:840-7.
Tretli S, Haldorsen T, Ottestad L. The effect of pre-morbid height and weight on the survival of breast cancer patients. Br J Cancer 1990;62:299-303.
Vasconcelos AB, Mendonça GAS, Sichieri R. Height, weight, weight change and risk of breast cancer in Rio de Janeiro, Brazil. São Paulo Med J 2001;119:62-6.
Hortobagui GN. Treatment of Breast Cancer. N Engl J Med 1998;339:974-84.
Chlebowski RT, Weiner JM, Reynolds R, Luce L, Bucalvage L, Bateman JR. Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. Breast Cancer Res Treat 1986;7:23-30.
Holmes MD, Stampfer MJ, Colditz GA, Rosner B, Hunter DJ, Willett WC. Dietary factors and the survival of women with breast carcinoma. Cancer 1999;86:826-35.
DeConti RC. Weight gain in the adjuvant chemotherapy of breast cancer. Proc Am Soc Clin Oncol 1982;1:73 (abstr C-279).
Bruning PF, Bonfrer JM, Hart AA. Non-protein-bound oestradiol, sex hormone binding globulin, breast cancer and breast cancer risk. Br J Cancer 1985;51:479-84.
Ingram DM, Nottage E, Ng S, Sparrow L, Roberts A, Dillcox D. Obesity and breast disease. The role of the female sex hormones. Cancer 1989;64:1049-53.
Ota DM, Jones LA, Jackson GL, Jackson PM, Kemp K, Bauman D. Obesity, non-protein-bound estradiol levels and distribution of estradiol in the sera of breast cancer patients. Cancer 1986;57:558-62.
Schapira DV, Kumar NB, Lyman GH. Obesity, body fat distribution, and sex hormones in breast cancer patients. Cancer 1991;67:2215-8.
Viganó A, Bruera E, Jhangri GS, Newman SC, Fields AL, Suarez- Almazor ME. Clinical survival predictors in patients with advanced cancer. Arch Intern Med 2000;160:861-8.
