Abstract
BackgroundImmunological biomarkers were related to quality of life and neuropsychological performance in women recently diagnosed with breast cancer through the first six months of treatment. A comparison group of breast cancer survivors in remission were also evaluated.MethodTwenty women newly diagnosed with breast cancer and 26 breast cancer survivors at least a year after treatment were evaluated four times over a course of six to 8 months. The assessments included quality-of-life, emotional and spiritual well-being, sleep quality, computerized neuropsychological performance, and cytokine immunology biomarkers using flow cytometry. The principal immunological markers examined were the CD4+, CD8+, and CD16+ counts.ResultsAlthough equivalent at enrollment, active treatment women reported higher anxiety, depression, poorer quality-of-life, and poorer processing speed and accuracy on memory, logical processes, and coding neuropsychological tasks. They also had significantly higher CD8+ and CD16+ cell count levels during treatment over the next six to eight months than comparison group women in remission. Women undergoing chemotherapy as well during treatment phase also had a significant decline in CD4+ counts. Higher percent CD8+ levels during treatment was associated with poorer quality of life and more depression, while higher CD4+ and CD8+ were associated with poorer neuropsychological memory and processing speed performance.ConclusionSignificant increases in CD8+ is a sensitive biomarker of a broad range of poorer quality-of-life and neurocognitive functioning outcomes during breast cancer treatment, especially in women undergoing chemotherapy. Quality of life should be monitored in breast cancer patients and psychosocial support made available as a standard of care.
Highlights
Immunological biomarkers were related to quality of life and neuropsychological performance in women recently diagnosed with breast cancer through the first six months of treatment
Significant increases in Cytotoxic T cells (CD8)+ is a sensitive biomarker of a broad range of poorer quality-of-life and neurocognitive functioning outcomes during breast cancer treatment, especially in women undergoing chemotherapy
Quality of life should be monitored in breast cancer patients and psychosocial support made available as a standard of care
Summary
Immunological biomarkers were related to quality of life and neuropsychological performance in women recently diagnosed with breast cancer through the first six months of treatment. The treatment of breast cancer is a complex process that involves more than treating a tumor. The women undergoing treatment deal with many levels of psychological events, including fighting a life-threatening disease with toxic therapies, changes in physical appearance, and managing the intricacies of the complex medical system. Stress and mood disturbance arising from the breast cancer journey can significantly modify immunological response during the course of treatment [2]. The psychospiritual profile of women can impact on the efficacy of cancer chemotherapy and its immunological impact [3]. Maes et al (1992) found that in major depression that there was an increase in CD4/CD8 T-lymphocytes, [4] and Sephton et al (2009) found that women displaying more depressive symptoms had weaker immune system response [5]
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