Symptoms In Breast Cancer Patients Research Articles

An Open, Uncontrolled Pilot Study on 12-Week Use of VagiVital for Treatment of VulvovaginalAtrophy in Breast Cancer Patients Undergoing Adjuvant Aromatase-Inhibitor Therapy.

PurposeThis pilot study assessed the efficacy of 12 weeks of daily treatment with a vaginal gel based on a water-based cellulose gel in reducing the severity of moderate–severe symptoms of vulvovaginal atrophy (VVA) and followed adverse events in female breast cancer patients undergoing treatment with adjuvant aromatase- inhibitor therapy.MethodsIn this open, uncontrolled pilot study, the efficacy and safety of the gel during a treatment period of 12 weeks (daily 1×1 mL) were evaluated (n=28). The gel is made of water and hypromellose, a hydropropylmetyl cellulose, which works by coating the vagina, and was developed to treat moderate–severe symptoms of VVA. The primary efficacy variable was the most bothersome symptom (MBS; among vulvovaginal irritation and itching, vaginal dryness, dysuria, or dyspareunia) self-identified at baseline on a four-point scale.ResultsA total of 28 patients fulfilled all entry criteria and had data available after the start of treatment. Treatment with the gel reduced MBS scores from baseline (n=28, mean 2.71) to week 12 (n=27, mean 1.33, mean reduction 1.37; p=0), and reduced the overall total scores for VVA symptoms from a mean of 5.39 at baseline to 2.25 at week 12 (p=0). Eleven subjects (39%) reported 19 AEs.ConclusionA 12-week treatment with the gel significantly reduced the severity of MBSs and VVA symptoms, improved quality of life, and was safe to use in women with breast cancer undergoing adjuvant aromatase-inhibitor therapy. In view of the beneficial effects of nonhormonal treatments, for cancer patients in particular, the water-based cellulose gel VagiVital is a suitable candidate for first-choice treatment of VVA symptoms in breast cancer patients and in women predisposed to cancer.

The impact of chemotherapy on subjective cognitive complaints in breast cancer: Evidence from pooled analyses with longitudinal studies.

e24050 Background: Subjective cognitive impairment (SCI) is one of the most commonly occurring symptoms in breast cancer patients. Chemotherapy (CTX) may be an important contributing factor to SCI, yet its association with SCI has been inconclusive. The meta-analysis with longitudinal data can provide more conclusive evidence as to the impact of CTX on SCI. This meta-analysis aimed to (a) determine whether CTX is associated with time-dependent SCI outcomes in breast cancer patients with pooled longitudinal data and (b) identify at the time point with the highest impact of CTX on SCI. Methods: Data were collected from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library in November 2020. Effect sizes (Hedges’ g) were calculated for the mean differences of the SCI level between the CTX treated patients and controls. Data were analyzed by and across clinical time periods; during CTX, within 1-month-post CTX, within 1-year-post CTX, and 1-year or longer post-CTX. Results: The longitudinal data were pooled with 9 data sets from 13 studies, including 857 patients treated by CTX, 410 patients not treated by CTX, and 517 healthy subjects. At baseline, CTX patients showed significantly better SCI compared to the non-CTX patient controls (ES=0.17, p=.031) and did not differ from healthy controls (ES = -0.04, p = .77). The CTX-treated patients had significantly worse SCI compared to both type of controls after initiating CTX. The effect sizes for the group differences were larger for the group comparison with healthy controls than the non-CTX control (- 0.16 for the comparison with non-CTX control, -0.51 for comparison with the healthy control). The largest time effect was found at the time point of within 1-month-post CTX in comparison with the healthy control (- 0.81). Conclusions: Our analysis indicated the association of CTX with SCI. Yet, more studies are needed to confirm the impact of CTX as (a) the effect size for the comparison with non-CTX control is very small and (b) limited data on the comparison with controls at the time point during active CTX and immediately after CTX. [Table: see text]

Association of single nucleotide polymorphisms of cytochrome P450 enzymes with experience of vasomotor, vaginal and musculoskeletal symptoms among breast cancer patients: a systematic review

BackgroundAdjuvant endocrine therapies are known to induce undesirable adverse effects such as vasomotor, vaginal and musculoskeletal symptoms among breast cancer patients. Drugs used in these therapies are often metabolised by cytochrome P450 (CYP) enzymes, in which their metabolising activities can be modified by single nucleotide polymorphisms (SNP) in CYP genes and CYP genotypes. This review aims to explore whether SNPs or genotypes of CYP are associated with the occurrence, frequency and severity of vasomotor, vaginal and musculoskeletal symptoms in breast cancer patients on adjuvant endocrine therapies.MethodsA literature review was conducted using five electronic databases, resulting in the inclusion of 14 eligible studies, and their findings were presented narratively. Selected items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist were used for critical appraisal of the reporting quality of the included studies.ResultsMost of the included studies showed that SNPs or genotypes of CYP that modify its metabolising activity have no effect on the occurrence, frequency or severity of vasomotor symptoms, including hot flashes. One study showed no correlation of these genetic variations in CYP with musculoskeletal symptoms, and no data were available on the association between such genetic variations and vaginal symptoms.ConclusionsOverall, genetic variations in CYP have no effect on the experience of hot flashes among breast cancer patients. We recommend exploration of the link between the active metabolites of chemotherapeutic drugs and the molecules shown to affect the occurrence or severity of hot flashes, and the establishment of the relationship between such genetic variations and patients’ experience of musculoskeletal and vaginal symptoms. Subgroup analyses based on patients’ duration of adjuvant endocrine therapies in such studies are recommended.

Impact of Intravenous Vitamin C Administration in Reducing Severity of Symptoms in Breast Cancer Patients During Treatment.

IntroductionAlternative medicine during treatment is often used to make the quality of life (QoL) better. Women with early-stage breast cancer, particularly the ones who possess lower QoL, are more prone to opt for complementary medicine. This study aims to explore the effects exerted by intravenous vitamin C (IVC) on symptoms and adverse events associated with breast cancer treatment.MethodsThis single-center, parallel-group, single-blind interventional study was conducted in the oncology ward of a tertiary care hospital in Pakistan. For this study, after informed consent was taken, breast cancer patients with Union for International Cancer Control stages IIA to IIIb were included in the study. Three hundred and fifty (n = 350) patients were randomized into two groups at a ratio of 1:1. Study group was randomized to receive 25 grams per week of IVC at a rate of 15 grams per hour for four weeks in addition to their current standard treatment, and the control group received placebo (normal saline drip with label removed) in addition to their current standard treatment.ResultsIn patients who had received IVC, there was a significant decrease in the mean severity score after 28 days for the following symptoms: nausea (2.65 ± 0.62 vs. 2.59 ± 0.68; p-value: 0.0003), loss of appetite (2.26 ± 0.51 vs. 2.11 ± 0.52; p-value: 0.007), tumor pain (2.22 ± 0.45 vs. 1.99 ± 0.40, p-value: <0.0001), fatigue (3.11 ± 0.32 vs. 2.87 ± 0.29; p-value: <0.0001), and insomnia (2.59 ± 0.35 vs. 2.32 ± 0.36, p-value: <0.0001).ConclusionOur study showed improvement in the mean severity score of nausea, fatigue, tumor pain, loss of appetite, and fatigue. More studies are also needed to assess the long-term effects of IVC in the cancer management. This shall help incorporate the use of IVC in standard practice to make the journey of cancer management comfortable for the patients.

The relationship between optimism, hope and spirituality with severity of symptoms in breast cancer patients in Tehran

The relationship between optimism, hope and spirituality with severity of symptoms in breast cancer patients in Tehran

COVID-19 Pandemic Stressors and Psychological Symptoms in Breast Cancer Patients.

Background. The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. Methods. Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. Results. Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. Conclusions. Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.

Cytoplasmic pollen extract for treatment of menopausal symptoms in breast cancer patients: a case series report

Objective: Menopausal symptoms, such as hot flushes (HFs), night sweats, vaginal dryness, psychological symptoms, and sexual dysfunction are a significant issue in breast cancer (BC) survivors, especially in those with hormone receptor-positive (HR+) subtype. Since hormone replacement therapy (HRT) is not indicated in these patients due to its estrogenic activity, we sought to investigate the role of cytoplasmic pollen extract (Femal®) with non-estrogenic effects as an adjuvant treatment in BC women. Methods: This case series study included 12 women with HR+, eight with Luminal A and four with Luminal B cancers, with a median age of 47 years (range 37-53) who received cytoplasmic pollen extract for 3 months. Menopause symptomatology was monitored through the Menopause Rating Scale (MRS) at the beginning of the treatment (T0) and at 90 days (T3). Tolerance was evaluated by the European Organization for Research and Treatment of Cancer (EORTC) score. Results: After 3 months of treatment, all cases had an improvement in HFs, cardiac symptoms, irritability and anxiety symptoms. No side effects were found. Tolerance and compliance were excellent during the study. Conclusions: This observational study suggests that cytoplasmic pollen extract is well tolerated when administered to BC (HR+) women with contraindications to HRT together with a positive impact on the patient’s menopausal related symptoms. However, longer follow-up afand future randomized studies are needed.

Detection significance of miR-3662, miR-146a, and miR-1290 in serum exosomes of breast cancer patients.

The potential relationship between exosomal microRNAs (miRNAs) and clinical symptoms in breast cancer patients and the expression levels of exosomal miRNAs in patients undergoing surgery and chemotherapy are still unclear. The aim of this study was to explore the correlation among exosomal miRNAs and clinical features and treatment in breast cancer patients. First, exosomes were isolated from the serum of patients with breast cancer and healthy controls. Next, the features of exosomes were identified by transmission electron microscopy, nanoparticle tracking analysis, and Western blot assays. Then, we detected the expression of the top-ranked miRNAs (miR-3662, miR-16-1, miR-146a, miR-1290, and miR-29c) in sixty breast cancer patients and twenty healthy controls using quantitative real-time polymerase chain reaction. The differential expression was measured by the Mann-Whitney U-test. The relative expression of miR-3662, miR-146a, and miR-1290 in serum exosomes was significantly higher in patients than healthy controls. Moreover, significant differences were found in the lymph node metastasis and clinical stage of breast cancer as the miRNA levels changed, but their expression levels in exosomes and sera were not correlated. In addition, exosomal miR-3662, miR-146a, and miR-1290 were shown to be valuable biomarkers to monitor patient condition in the course of surgery and chemotherapy. Exosomal miR-3662, miR-146a, and miR-1290 may have promising predictive value and could be utilized as biomarkers for diagnosis and preventative strategy development.

Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant).

Background:Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients.Methods:We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii.Results:Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effectsConclusions:Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer.Registration number:CRD42018087813

Genetic Variation Associated With Depressive Symptoms in Breast Cancer Patients: A Systematic Review.

Depressive symptoms are highly prevalent in breast cancer patients. These symptoms can contribute to lower treatment adherence, increased healthcare charges, and higher mortality rates. Growing evidence suggests that genetic variations may be associated with depressive symptom susceptibility. To comprehensively review current findings on the association of genetic variations with depressive symptoms in breast cancer patients. A literature search was conducted using keywords such as gene variation, single-nucleotide polymorphism, depression/depressive symptoms, and breast cancer. Four hundred articles were retrieved from PubMed, Web of Science, CINAHL, and PsycINFO, yielding 9 full-text, data-based articles. The study quality was assessed using the STrengthening the REporting of Genetic Association studies guideline. Genetic polymorphisms in brain-derived neurotrophic factor (BDNF), interferon γ receptor 1 (IFNGR1), interleukin-6 (IL-6), tumor necrosis factor α (TNFA), and IL-1B were found to be associated with depressive symptoms among breast cancer patients. The role of serotonin transporter gene linked promotor region (5-HTTLPR) functional polymorphisms on depressive symptoms was inconclusive. The overall quality of reporting results and methods was medium. This is the first review of genetic variations related to differences in levels of depressive symptoms among breast cancer patients. Genetic polymorphisms in inflammatory, neuronal system, and signal transduction pathways can influence the susceptibility. However, more research regarding this topic is needed to further clarify genetic risk factors. Healthcare providers may determine patients at higher risk of developing depression and symptom outcomes if genetic biomarkers with good sensitivity/specificity are provided. This knowledge can potentially help the development of personalized treatment and decision making for those patients.

Suppression of Long Non-Coding RNA Metastasis-Associated Lung Adenocarcinoma Transcript 1 (MALAT1) Potentiates Cell Apoptosis and Drug Sensitivity to Taxanes and Adriamycin in Breast Cancer.

BackgroundThe long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is expressed highly in various types of tumors. Moreover, the tumor-initiating role of MALAT1 has been probed in the context of breast cancer. This study was set to investigate the regulatory role of MALAT1 on the chemosensitivity of breast cancer cells to taxanes (Tax) and adriamycin (Adr).Material/MethodsFollowing the measurement of MALAT1 expression in patients with breast cancer by means of qRT-PCR, the connection between the MALAT1 expression pattern and the prognosis of breast cancer patients as well as the molecular typing of breast cancer patients was analyzed using Kaplan-Meier survival analysis and receiver operating characteristic (ROC) curves. Next, the analysis between the expression of MALAT1 and the clinical symptoms of breast cancer patients was carried out. Subsequently, we generated taxane-resistant MCF-7 cells (MCF-7/Tax) and purchased Adr-resistant MCF-7 cells (MCF-7/Adr). Finally, the proliferation, apoptosis and drug resistance of resistant and parental cells were evaluated after transfection of silencing MALAT1 into these cells.ResultsMALAT1 was highly expressed in the breast cancer tissues. Moreover, patients with relative overexpression of MALAT1 had worse prognosis. MALAT1 expression was remarkably promoted in MCF-7/Tax and MCF-7/Adr cells, whose sensitivity to Tax and Adr was enhanced following MALAT1 knockdown.ConclusionsMALAT1 was elevated in breast cancer tissues and MCF-7-resistant cells, relative to corresponding controls and downregulation of MALAT1 inhibited the growth and chemoresistance of breast cancer cells to Tax and Adr.

Immunological changes with perception of cold in breast cancer (BC) patients.

e12559 Background: Tumor-bearing mice “feel colder” than non-tumor bearing mice and prefer to be at thermoneutral temperatures. Cold stress results in immunosuppressive tumor microenvironment [decrease in CD8+T-cells, increase in myeloid derived suppressor cells and T-regulatory cells]. Cytokines play a significant role in modulating these immune cells. Breast cancer (BC) patients frequently report feeling excessively cold under ambient temperature. We examined the association between cytokine levels and thermal discomfort symptoms in BC patients in the Women’s Health After Breast Cancer (ABC) Study treated at Roswell Park Comprehensive Cancer Center. Methods: 424 stage I-III BC patients were identified. Standard demographics, body mass index (BMI), race, grade, histological subtype, tumor size, stage, nodal status, treatment received, and menopausal status were recorded. Peripheral blood was prospectively collected at diagnosis and one year post diagnosis and analyzed for a panel of 27 cytokines. Patients completed a questionnaire reporting symptom of “feeling cold when others are fine” using a Likert scale one year post BC diagnosis. Relationships between cytokines levels as tertiles and symptoms of “feeling cold” were evaluated using logistic regression. Change in cytokine levels from the time of BC diagnosis to one year post were also evaluated [ &gt; 20% decrease, no change (-20 to +20%), and &gt; 20% increase]. Results: Overall, 195/424 (46%) patients reported “feeling cold”. There were no differences in patient and tumor characteristics between patients who reported “feeling cold” vs “not cold.” Interestingly, 53.4% patients on chemotherapy reported “feeling cold” (p &lt; 0.05). At baseline, higher IL-17E and IL-6 were associated with decreased perception of feeling cold (p &lt; 0.05, p &lt; 0.01). At one year post diagnosis, higher TNF-β was associated with decreased perception of feeling cold (p &lt; 0.05). Changes in IL-22 and IL-33 were associated with increased perception of feeling cold (p &lt; 0.05, p &lt; 0.05). Multivariate model adjusted for age, race, BMI, histological subtype, stage, grade, treatment and menopausal status showed a trend towards decreased cold perception with higher IL-6 but was not statistically significant. Conclusions: We observe significant differences in pro-tumorigenic IL-6 and anti-tumorigenic IL-17E &amp; TNF-β cytokines in BC patients reporting thermal discomfort. This suggests avenues for using thermal therapies to modulate inflammatory cytokine production in breast cancer.

Objective and subjective vulvovaginal symptoms in breast cancer patients.

e24056 Background: Breast cancer and its treatment adversely impact sexual function and QoL. As more women become survivors, information is needed about vulvovaginal symptoms, sexual concerns and treatment options. Methods: An IRB Limited Waiver of Authorization was obtained to evaluate the medical records of 650 breast cancer patients with initial sexual medicine consults between 7/19/12 &amp; 3/5/19. All women completed the Clinic Assessment form including a pelvic exam checklist, vulvovaginal tissue quality assessment (Vaginal Assessment Scale (VAS)/Vulvar Assessment Scale (VuAS) and sexual function measures (FSFI, PROMIS-SF) at initial visit and 56% (366/650) completed it at follow-up visits. R v3.6.1 was used to perform statistical analysis. Results: Women were categorized at initial consult as either postmenopausal (PM), pre/perimenopausal or menopausal from ovarian suppression (OS). Median age at initial consult was 52 (range 26 to 83) and median endocrine exposure ranged from 12 months on Tamoxifen only to 52 months on Tamoxifen followed by an AI. Of the total sample, 60% reported no confidence in future sexual activity and 68% reported pelvic pain with exam at initial consult. Improvements were seen at the first follow-up in confidence about intimacy and sexual health concerns (p &lt; .001). Vulvovaginal symptoms (VAS/VuAS) and dilator and vulvovaginal moisturizer use (p &lt; .001) also improved from baseline to follow-up 1. The women most likely to attend first follow-up appointments were OS (70%) and PM women on AIs (64%) who also reported worse symptoms at baseline compared to pre/perimenopausal women on Tamoxifen. At initial presentation, PM on AIs and OS had poor exam outcomes respectively: pH &gt; 5 (92%; 83%), poor vaginal elasticity (19%; 13%), vaginal dryness (88%; 68%), decreased rugosity (36%; 30%) and poor vascularity (33%; 21%). At initial consult, exam findings for pH, moisture, vulvar and vestibular irritation each correlated significantly with patient reported vaginal (VAS total score) and vulvar (VuAS total score) symptoms (p≤ .05). Conclusions: Breast cancer patients can benefit from coordinated multidisciplinary care addressing the long-term effects of premature menopause and endocrine therapy. Patient characteristics such as menopausal status and type/duration of endocrine therapy should be considered when assessing sexual health since aromatase inhibitors and ovarian suppression appear to worsen clinical exam and patient reported outcomes. Sexual health counseling and treatment can help women cope with sexual concerns during and after breast cancer therapy.

Inflammatory Biomarkers, Hematopoietic Stem Cells, and Symptoms in Breast Cancer Patients Undergoing Adjuvant Radiation Therapy.

BackgroundFatigue and insomnia are common symptoms experienced by breast cancer patients undergoing adjuvant radiation therapy (RT), yet the underlying mechanisms of these symptoms are unclear. In particular, the roles of hematopoietic stem cells (HSCs) and inflammatory cytokines remain to be elucidated.MethodsBreast cancer patients (n = 147) completed questionnaires to longitudinally assess symptoms before, during, and after adjuvant RT. Phlebotomies were performed prior to RT, at the second and fifth treatment fractions, end of treatment (EOT), and 1 month after completing RT, assessing for CD34+, CD45+, full hematology, and 17 inflammatory cytokines. The associations between symptoms and all biomarkers were evaluated. All statistical tests were 2-sided.ResultsGeneral fatigue and insomnia worsened with RT, with peak levels observed at EOT, which remained statistically significant even after controlling for anxiety and depression (P < .05 for all). CD34+, CD45+, white blood cell, and lymphocyte counts decreased, with the lowest levels also observed at EOT (P < .001). Fatigue and insomnia were associated with changes in both interferon γ-induced protein 10 (IP-10) - (P = .03 and P = .01, respectively) and tumor necrosis factor receptor II (TNF-RII) (P = .02 and P = .006, respectively), while mental fatigue was associated with increased matrix metalloproteinases-2 (MMP-2) levels (P = .03). Patients who received prior chemotherapy demonstrated statistically significantly greater severity in all symptoms, with lower baseline HSC levels.ConclusionsThis is the first longitudinal study to examine linkages between symptoms, HSCs, and cytokines, demonstrating that fatigue and insomnia shared associations with increasing serum levels of IP-10 and TNF-RII, and mental fatigue was associated with increasing serum levels of MMP-2. Our findings highlight opportunities for further research into mechanisms and potential interventions for these symptoms.

Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial

Chemotherapy causes various side effects, including cognitive impairment, known as ‘chemobrain’. In this study, we determined whether a novel acupuncture mode called electroacupuncture trigeminal nerve stimulation plus body acupuncture (EA/TNS + BA) could produce better outcomes than minimum acupuncture stimulation (MAS) as controls in treating chemobrain and other symptoms in breast cancer patients. In this assessor- and participant-blinded, randomized controlled trial, 93 breast cancer patients under or post chemotherapy were randomly assigned to EA/TNS + BA (n = 46) and MAS (n = 47) for 2 sessions per week over 8 weeks. The Montreal Cognitive Assessment (MoCA) served as the primary outcome. Digit span test was the secondary outcomes for attentional function and working memory. The quality of life and multiple functional assessments were also evaluated. EA/TNS + BA treated group had much better performance than MAS-treated group on reverse digit span test at Week 2 and Week 8, with medium effect sizes of 0.53 and 0.48, respectively, although no significant differences were observed in MoCA score and prevalence of chemobrain between the two groups. EA/TNS + BA also markedly reduced incidences of diarrhoea, poor appetite, headache, anxiety, and irritation, and improved social/family and emotional wellbeing compared to MAS. These results suggest that EA/TNS + BA may have particular benefits in reducing chemotherapy-induced working memory impairment and the incidence of certain digestive, neurological, and distress-related symptoms. It could serve as an effective intervention for breast cancer patients under and post chemotherapy (trial registration: https://www.clinicaltrials.gov: NCT02457039).

The influence of cognitive schemas on the mixed anxiety-depressive symptoms of breast cancer patients

BackgroundThe surgical treatment of breast cancer involves various psychological consequences, which differ according to individual characteristics. Our study aimed to identify the role that cognitive schemas had in triggering anxiety and depressive symptoms in patients diagnosed with breast cancer that underwent oncological and plastic surgery treatment.Methods64 female patients, diagnosed with breast cancer from an Oncology and Plastic Surgery Hospital, were selected to participate in this study between March–June 2018. They were divided into two groups: I. 28 patients who underwent mastectomy surgery; II. 36 patients, who required mastectomy and, subsequently, also chose to undergo breast reconstruction surgery. For the purposes of evaluating a possible change in mental health status, we employed two assessment scales: the Young Cognitive Schema Questionnaire - Short Form 3 (YSQ-S3) and the Romanian version of the Depression Anxiety Stress Scale – 21 (DASS-21R).ResultsParticipants who underwent mastectomy and subsequent breast reconstruction surgery employed cognitive schemas that did not generate symptoms of depression or anxiety. In contrast, the cognitive schemas found in women who refused reconstructive breast surgery were significantly correlated with the presence of anxiety-depressive symptoms. The cognitive schema domain of ‘disconnection and rejection’ correlated uncertainly with the presence of anxiety-depressive symptoms for the group with breast reconstruction (Spearman’s ρ = 0.091, p = 0.644), while for the other group the correlation was moderate-strong (Spearman’s ρ = 0.647, p < 0.01). Negative emotional schemas were significantly correlated with the presence of anxiety-depressive symptoms (Spearman’s ρ = 0.598, p < 0.01) in the group of participants without reconstructive surgery.ConclusionA correct identification of dysfunctional cognitive schemas and coping mechanisms at the commencement of the combined treatment in breast cancer patients could serve as an indicator for the evolution of their mental health, therefore assisting professionals in establishing the most suitable psychological, psychotherapeutic and psychiatric intervention plan.

Long-Term Favorable Effects of Physical Exercise on Burdensome Symptoms in the OptiTrain Breast Cancer Randomized Controlled Trial.

Purpose: We evaluate longitudinal changes in symptom clusters and core burdensome symptoms in breast cancer patients who participated in the OptiTrain trial. Methods: 240 women were randomized to 16 weeks of supervised exercise (RT-HIIT or AT-HIIT) or usual care (UC) during adjuvant chemotherapy. Symptom clusters were composed using the Memorial Symptom Assessment Scale (MSAS), assessed at baseline, 16 weeks and 12 months later. Three symptom clusters were formed. Results: Three symptom clusters were identified: “emotional,” “treatment-related toxicity,” and “physical,” with core burdensome symptoms present over time. At 16 weeks, the reported burdens of “feeling sad” (RT-HIIT vs UC: effect size [ES] = −0.69; AT-HIIT vs UC: ES = −0.56) and “feeling irritable” (ES = −0.41 RT-HIIT; ES = −0.31 AT-HIIT) were significantly lower in both intervention groups compared with UC. At 12 months, the AT-HIIT group continued to have significantly lower scores for the core burdensome symptoms “feeling sad” (ES = −0.44), “feeling irritable” (ES = −0.44), and “changes in the way food tastes” (ES = −0.53) compared with UC. No between-group differences were found for physical symptoms. Conclusion: We identified 3 symptom clusters in breast cancer patients during and after adjuvant chemotherapy, composed of “emotional,” “treatment-related toxicity,” and “physical” symptoms. After treatment completion up to 12 months post-baseline, patients in the physical exercise groups reported lower symptom burden scores for emotional symptoms, compared with UC. Our findings indicate a preserved and long-term beneficial effect of physical exercise on self-reported emotional well-being in chemotherapy-treated breast cancer patients.

The influence of cognitive emotion regulation strategies on depressive symptoms in breast cancer patients

The influence of cognitive emotion regulation strategies on depressive symptoms in breast cancer patients

Is Tamoxifen Use a Factor Affecting Continence in Breast Cancer Patients?

Introduction: Tamoxifen treatment has been shown to reduce the recurrence and mortality rates in hormone receptor-positive breast cancers independent from chemotherapy. This benefit increases with the prolongation of the use of tamoxifen but with increasing side effects. In this study, we aim to evaluate the presence of urogenital symptoms in breast cancer patients on tamoxifen and compare them with those who are not on any hormonotherapy.Materials and methods: This study was performed on patients diagnosed as early-stage breast cancer. The study group consisted of hormone receptor-positive patients given tamoxifen as adjuvant hormonal therapy. The control group consisted of breast cancer patients who had no hormonotherapy. Patients with a complaint of urinary incontinence with onset after tamoxifen usage were evaluated with Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire Short Form (IIQ-7) and Incontinence Quality of Life Questionnaire (I-QOL).Results: A total of 137 early-stage breast cancer patients were included in this study; 74 estrogen receptor-positive patients on tamoxifen therapy (study group) and 63 hormone receptor-negative patients with no hormonotherapy (control group). The median age was 44 (30-65) years for tamoxifen users and 49 (27-64) years for the control group. The stages of the patients were similar for both groups. 78.4% of the women in the tamoxifen group and 49.2% in the control group were in the premenopausal period. The groups were similar in regard to body mass index and parity. The complaint of urinary incontinence was more frequent in the study group compared to controls (39 (52.7%) vs. 5 (7.9%)). Women with the complaint of urinary incontinence were evaluated with self-reported UDI-6, IIQ-7 and I-QOL forms and the scores were similar for both study and control groups. A statistically significant relation was observed between cigarette smoking and the presence of urinary incontinence. The percentages of smokers were 50% of those with incontinence and 24.7% of those without incontinence.Conclusion: Urinary incontinence is positively correlated with tamoxifen usage in early-stage breast cancer patients.

Moderators of Cognitive Therapy and Bright Light Therapy Effects on Depressive Symptoms in Patients with Breast Cancer.

Cognitive therapy (CT) and bright light therapy (BLT) have been found to be effective to treat depressive symptoms in breast cancer patients. No study has investigated the baseline patients' characteristics that are associated with better outcomes with CT vs. BLT in this population. This study aimed to assess, in breast cancer patients, the moderating role of eight clinical variables on the effects of CT and BLT on depressive symptoms. This is a secondary analysis of a randomized controlled trial conducted in 59 women who received an 8-week CT or BLT and completed questionnaires evaluating depression and possible moderating variables. Patients benefited more from BLT when they had no prior history of major depressive disorder, higher depression scores on the Hospital Anxiety and Depression Scale (HADS-D) at baseline, a greater initial preference for BLT, and when they received BLT during spring or summer. Patients benefited more from CT when they had a lower initial preference for receiving CT, higher depression scores on the HADS-D, and seasonal depressive symptoms. Although replication is needed, findings of this study suggest the existence of different profiles of patients more likely to benefit from CT and BLT. NCT01637103 https://clinicaltrials.gov/ct2/show/NCT01637103.