In a nutshell
This study investigated the effects of specific lifestyle factors in the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients. This study found that obesity, antioxidant supplements and physical activity were associated with CIPN.
Some background
CIPN, or damage to the nerves, is a possible side effect of taxane-based chemotherapy (such as docetaxel). CIPN may lead to weakness, numbness, tingling and pain in the hands and feet.
There is growing evidence that lifestyle factors can affect the onset and severity of CIPN. Body mass index (BMI, a measure of body fat that takes height and weight into account) and antioxidants (supplements like vitamins C or E that are thought to prevent cell damage) have been associated with CIPN in different types of cancer. Physical activity and diet have been associated with neuropathy in diabetic patients. It is not clear how these lifestyle factors together affect the risk or severity of CIPN in breast cancer patients.
Methods & findings
This study included 1237 women treated with taxane-based chemotherapy for invasive breast cancer. The women were categorized as normal (BMI less than 25 kg/mg2), overweight (BMI 25–29.9 kg/mg2) or obese (BMI 30 kg/mg2 or more). Lifestyle data was collected by interview and questionnaire. Questions included time spent taking part in moderate-to-vigorous physical activity and intake of fruits/vegetables and antioxidant supplements. Patients were assessed after 6 months and 24 months.
Of the women, 65.6% were overweight or obese. 29.9% took part in low amounts of physical activity, 57.5% had low fruit/vegetable intake and 31.8% reported taking antioxidants during chemotherapy.
The odds of developing CIPN were 2.37 times higher in overweight patients and 3.21 times higher in obese patients compared with normal-weight patients at 24 months. Patients who spent more than 5 hours per week on physical activity were 57% less likely to have increased CIPN after 24 months than those who exercised less. Women who began use of antioxidant dietary supplements near the time of receiving chemotherapy had 3.81 times the odds of increased CIPN after 6 months compared to non-users. Fruit and vegetable intake was not associated with the risk of CIPN.
The bottom line
This study concluded that obesity, low physical activity and a change in the use of antioxidants is associated with more severe CIPN symptoms in breast cancer patients receiving taxane chemotherapy.
The fine print
Patients who remained in the study for 24 months were generally more health conscious. Lifestyle factors were reported by the patients. The data on antioxidant effects were only collected at baseline and 6 months, and is limited by small sample size. This study included only women with breast cancer. It is not clear if the risks are the same for male patients.
What’s next?
If undergoing taxane chemotherapy consult your doctor about healthy lifestyle changes and supplement use and their effect on CIPD.
Published By :
Journal of the National Cancer Institute (JNCI)
Date :
Feb 01, 2017
