The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges

2017 ◽  
Vol 78 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Vivienne Vance ◽  
Sharon Campbell ◽  
Linda Mccargar ◽  
Marina Mourtzakis ◽  
Rhona Hanning
Keyword(s):  
Breast Cancer ◽  
Food Intake ◽  
Weight Change ◽  
Early Stage ◽  
Qualitative Interviews ◽  
Dietary Interventions ◽  
Related Factors ◽  
Food Cravings ◽  
Psychosocial Challenges ◽  
The Voice

Purpose: This study investigated relationships between psychosocial and treatment-related factors, diet, and weight change in women treated with chemotherapy for early-stage breast cancer. Methods: Comprehensive qualitative interviews were conducted with 28 women who were within 12 months of completing chemotherapy treatment. Results: Changes in food intake and eating patterns were universal over the course of chemotherapy, with broad variability in treatment effects and associated dietary responses linked to weight change. Increased appetite, food cravings, and intake of energy-dense comfort foods were more common among women who gained weight during treatment (n = 11). Changes in taste, nausea, and emotional distress were central in promoting these dietary responses. Women who lost weight during treatment (n = 6) tended to report more severe and persistent side effects of treatment leading to poor appetite and lower food intake, and they were more likely to live alone. Conclusions: While the etiology of weight change in this population is complex, this study suggests that changes in food intake related to treatment and psychosocial challenges may play an important role for some women. These findings may help to identify women who are most at risk of weight change during treatment and may inform the development of tailored dietary interventions.

scholarly journals Female Breast Cancer in Suriname: Pathways to Treatment—A Patient’s Perception

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Euridice R. Irving ◽  
Dennis R. A. Mans ◽  
Els Th. M. Dams ◽  
Maureen Y. Lichtveld
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Access To Health Care ◽  
Early Stage ◽  
Diagnosis And Treatment ◽  
Related Factors ◽  
Entire Interval ◽  
Early Stage Disease ◽  
Resource Setting ◽  
Stage Disease

PURPOSE Delays across the entire cancer care continuum are not uncommon. This cross-sectional study explored the health care trajectories of Surinamese women with breast cancer and identified predictors of timely diagnosis and treatment initiation. METHODS One hundred women age 30 years or older who were newly diagnosed with breast cancer in 2017 to 2018 were recruited from all 4 hospitals in Paramaribo. Data on their demographics, lifestyle, reproductive and medical history, health status, and family history of breast cancer and other malignancies were collected using a validated semistructured questionnaire. Using Anderson’s Model of Pathways to Treatment, we defined a patient interval (from detection to first consultation), diagnostic interval (from consultation to histopathologic diagnosis), and treatment interval (from diagnosis to first treatment). Log-transformed data were analyzed using linear regression, and variables with P ≤ .05 were considered statistically significant predictors of intervals. RESULTS All participants had health insurance and access to health care. Eighty-five percent of patients presented with early-stage disease. Ninety percent of patients had self-detected their disease, with 70% finding a lump. Average age was 55.6 years (± 11.8 years). Median durations of patient, diagnostic, and treatment intervals were 13 days (interquartile, range, 4-63 days), 40 days (IQR, 21-57 days), and 18 days (IQR, 8-38 days), respectively. Median duration of the entire interval was 95 days (IQR, 59-272 days). Patient-related factors associated with the intervals were religion (β = −530; P = .003), being employed (β = 149.4; P = .007), and age 50 years and older (β = −195.8; P = .037). Disease-related factors were lump as first symptom (β = −175.6; P = .038) and late-stage disease at diagnosis (β = 213.5; P = .004). CONCLUSION Given the limited-resource setting, delays in Suriname’s health care can be minimized by programs aimed at increasing breast cancer awareness and education; however, delays may have been underestimated as a result of the over-representation of early-stage disease and recall bias regarding the first symptom detected.

Quality of life in breast cancer sufferers

2016 ◽  
Vol 29 (7) ◽  
pp. 721-732 ◽  
Author(s):  
Ahmed Essmat Shouman ◽  
Nahla Fawzy Abou El Ezz ◽  
Nivine Gado ◽  
Amal Mahmoud Ibrahim Goda
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Family Income ◽  
Early Stage ◽  
Functional Domain ◽  
Related Factors ◽  
Specific Patient ◽  
Content Type ◽  
Factors Affecting

Purpose – The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients. Design/methodology/approach – A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used. Findings – The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence – a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores. Originality/value – The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores.

Attention to diet, exercise, and weight in the oncology clinic: Results of a national patient survey.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10549-10549
Author(s):  
Jennifer A. Ligibel ◽  
Lori J. Pierce ◽  
Catherine M. Bender ◽  
Tracy E Crane ◽  
Christina Marie Dieli-Conwright ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Online Survey ◽  
Early Stage ◽  
Cancer Type ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Increased Risk ◽  
Diet And Exercise ◽  
To Receive

10549 Background: Obesity and related factors are increasingly associated with increased risk of developing and dying from cancer. The American Society of Clinical Oncology (ASCO) conducted a survey of cancer patients to assess their experience in receiving recommendations and referrals related to weight, diet and exercise as a part of their cancer care. Methods: An online survey was distributed to potential participants between March and June 2020 via ASCO channels and patient advocacy organizations, with an estimated reach of over 25,000 individuals. Eligibility criteria included being 18 years, living in the US, and having been diagnosed with cancer. Logistic regression was used to determine factors associated with recommendation and referral patterns. Results: In total, 2419 individuals responded to the survey. Most respondents were female (75.5%), 61.8% had an early-stage malignancy, 38.2% had advanced disease, and 49.0% were currently receiving treatment. Breast cancer was the most common cancer type (36.0%). Average BMI was 25.8 kg/m2. The majority of respondents consumed £2 servings of fruits and vegetables per day (50.9%) and exercised £2 times per week (50.4%). Exercise was addressed at most or some oncology visits in 57.5% of respondents, diet in 50.7%, and weight in 28.4%. Referrals were less common: 14.9% of respondents were referred to an exercise program, 25.6% to a dietitian and 4.5% to a weight management program. In multiple regression analyses, racial and ethnicity minority respondents were more likely to receive advice about diet (Odds Ratio [OR] 1.92, 95% CI 1.56-2.38) and weight (OR 1.64, 95% CI 1.23-2.17) compared to non-Hispanic whites, individuals diagnosed with cancer in the past 5 yrs (vs > 5 yrs) were more likely to receive advice about exercise (OR 1.48, 95% CI 1.23-1.79), and breast cancer patients were more likely to receive advice about exercise (OR 1.37, 95% CI 1.11-1.68) and weight (OR 1.46, 95% CI 1.03-2.07) than other cancer patients. Overall, 74% of survey respondents had changed their diet or exercise after cancer diagnosis. Respondents reporting that their oncologist spoke to them about increasing exercise or eating healthier foods were more likely to report a change in behavior than those whose oncologists did not (exercise: 79.6% vs 69.0%, P < 0.001; diet 81.1% vs 71.4%, P < 0.001). Respondents whose oncologist had spoken to them about exercise were more likely to exercise > 2 times per week compared to respondents whose oncologists did not address exercise (53.5% vs 44.1%, P < 0.001). Conclusions: In a national survey of oncology patients, slightly more than half of respondents reported attention to diet and exercise during oncology visits. Provider recommendations for diet and exercise were associated with positive changes in these behaviors. Additional attention to diet and exercise as part of oncology visits is needed to help support healthy lifestyle change in cancer patients.

Taking control of cancer: Women’s choice for mastectomy.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 11-11
Author(s):  
Andrea Marie Covelli ◽  
Nancy Baxter ◽  
Margaret Fitch ◽  
Frances Catriona Wright
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Prophylactic Mastectomy ◽  
Early Stage ◽  
Qualitative Interviews ◽  
Contralateral Prophylactic Mastectomy ◽  
Active Role ◽  
Breast Conserving Surgery ◽  
Fear Of Recurrence ◽  
Extensive Surgery

11 Background: Rates of both unilateral (UM) and contralateral prophylactic mastectomy (CPM) for early stage breast cancer (ESBC) have been increasing since 2003. Studies suggest that the increase is due to women playing an active role in decision-making. We do not know what factors are influencing the choice for more extensive surgery. Methods: To identify these factors we completed a multi-method study; conducting a systematic review of quantitative literature and qualitative interviews. Decision-making literature was identified from 5 databases and underwent thematic analysis. Purposive sampling identified women across the Toronto Area (Ontario, Canada), who were suitable candidates for breast conserving surgery (BCS) but underwent UM or CPM. Data saturation was achieved after 29 in-person interviews. Constant comparative analysis identified key concepts and themes. Results: ‘Taking control of cancer’ was the dominant theme. Literature illustrated that patients markedly overestimate risk of local recurrence, contralateral cancer and particularly, mortality. Similarly, interviews revealed that fear of breast cancer was expressed at diagnosis and drives the decision-making process. Despite surgeons discussing survival equivalence of BCS and UM, patients chose UM due to fear of recurrence and an overestimated survival advantage. Similarly, patients chose CPM to eliminate contralateral cancer and a misperceived survival benefit. Women were actively trying to Control Outcomes, as more surgery was believed to offer greater survival and therefore greater control. Conclusions: Both the literature and our interviews have illustrated that women seek UM and CPM for treatment of their ESBC to manage their fear of cancer mortality by undergoing more extensive surgery; this in turn drives mastectomy rates. It is important to understand this process so that we may improve our ability to communicate issues of importance to women and facilitate informed decision-making.

Seeking a no-regrets decision: Women's rationale for choosing contralateral prophylactic mastectomy (CPM).

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 152-152 ◽  
Author(s):  
Diane Bloom ◽  
Stephanie B. Wheeler ◽  
Kandace P McGuire ◽  
Clara Lee ◽  
Kevin Weinfurt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Early Stage ◽  
Qualitative Interviews ◽  
Low Risk ◽  
Theory Approach ◽  
Unilateral Breast Cancer ◽  
Peace Of Mind ◽  
Risk Of Cancer

152 Background: More women with early-stage unilateral breast cancer and low genetic risk are opting for CPM, despite their low risk of developing cancer in their healthy breast and evidence to demonstrate that CPM improves neither survival nor quality of life, while increasing the risk of surgical complications. Little is known about the factors that motivate this irreversible decision. Methods: We conducted comprehensive qualitative interviews with 42 women at low risk for contralateral breast cancer (CBC) who had CPM in the last 10 years. We recorded and transcribed the interviews and analyzed them using a grounded theory approach. Results: Contrary to hypotheses that newly diagnosed women overestimate their CBC risk, study patients knew of the low risk of cancer in their healthy breast, but still chose CPM. Statistics were unpersuasive; given healthy lifestyles and lack of risk factors, they felt unlucky to get breast cancer and feared they would be unlucky again. They believed CPM would give them more peace of mind and the fewest regrets should cancer return. Avoiding mammograms was important, given the potential for callbacks, biopsies, and more bad news. Avoiding radiation and wanting matching breasts were cited less often. Most were mainly focused on reducing their cancer risk and could not recall having critical information about CPM’s potential harms. A few knew of likely harms but misjudged their impact. When told of CPM’s higher risk of complications, most dismissed this as a disclaimer, believing they would get through surgery well. Despite experiencing negative effects of CPM, 38 of 42 stated they would make the same decision again. Conclusions: When choosing CPM, most women felt confident in making their decision, although many had incomplete knowledge of potential long-term impacts. Nevertheless the majority of women who chose CPM did not regret their decision, suggesting that women who elect CPM are selecting a treatment option that is consistent with their long-term personal values and preferences. While important to ensure women know potential long-term harms, our findings suggest they may not necessarily be dissuaded from CPM by more data, though they may be better prepared for it’s aftermath.

scholarly journals Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors

2017 ◽  
Vol 162 (3) ◽  
pp. 549-557 ◽  
Author(s):  
Elizabeth M. Cespedes Feliciano ◽  
Marilyn L. Kwan ◽  
Lawrence H. Kushi ◽  
Erin K. Weltzien ◽  
Adrienne L. Castillo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Weight Change ◽  
Cardiovascular Events ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Early Stage Breast Cancer

scholarly journals Effect of Postdiagnosis Weight Change on Hot Flash Status Among Early-Stage Breast Cancer Survivors

2012 ◽  
Vol 30 (13) ◽  
pp. 1492-1497 ◽  
Author(s):  
Bette J. Caan ◽  
Jennifer A. Emond ◽  
H. Irene Su ◽  
Ruth E. Patterson ◽  
Shirley W. Flatt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Hot Flashes ◽  
Breast Cancer Diagnosis ◽  
Intentional Weight Loss ◽  
Previously Treated

Purpose Hot flashes (HF) affect a large proportion of breast cancer (BC) survivors and can negatively affect their quality of life. Treatments other than estrogen replacement to alleviate HF are needed. Body weight is related to hot flashes, but little is known about the effect of weight change on HF. Patients and Methods We used data from 3,088 women previously treated for early-stage BC who were enrolled onto the Women's Healthy Eating and Living study to examine the association between weight change after a breast cancer diagnosis and the odds of reporting HF. Results Overall, 36.1% of participants reported moderate to severe HF at study entry. At 2 years postdiagnosis, 69.2% of women remained within 10%, 4.8% lost at least 10%, and 26.0% gained at least 10% of their prediagnosis weight. Those who gained at least 10% of their prediagnosis weight had a greater risk of reporting HF than women who remained weight stable in that same period (odds ratio [OR], 1.33; 95% CI, 1.11 to 1.60; P = .003). Weight loss of at least 10% of prediagnosis weight was associated with a nonsignificant reduced risk (OR, 0.72; 95% CI, 0.47 to 1.08; P = .118) of reporting HF. However, the trend of weight change (weight loss and weight gain) on HF was significant both when examined categorically (P = .03) and continuously (P < .001). Conclusion Prevention of weight gain after a BC diagnosis—a modifiable behavior—may offer a viable intervention for relief of HF. Effects of intentional weight loss in BC survivors requires further study.

scholarly journals Moderators of Interventions Designed to Enhance Physical and Psychological Functioning Among Younger Women With Early-Stage Breast Cancer

2007 ◽  
Vol 25 (36) ◽  
pp. 5710-5714 ◽  
Author(s):  
Michael F. Scheier ◽  
Vicki S. Helgeson ◽  
Richard Schulz ◽  
Suzanne Colvin ◽  
Sarah L. Berga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Psychosocial Factors ◽  
Early Stage ◽  
Nutrition Intervention ◽  
Early Stage Breast Cancer ◽  
Personality Factors ◽  
Psychosocial Resources ◽  
Related Factors ◽  
Younger Women ◽  
The Impact

Purpose To identify factors that condition or moderate the impact of a previously described set of interventions on psychological and physical adjustment after diagnosis and treatment for early-stage breast cancer. Patients and Methods Younger women (age < 51 years, N = 252) with early-stage breast cancer within 2 months of having completed active nonhormonal adjuvant therapy were randomly assigned to a three-arm clinical trial, consisting of a control arm, an education arm, and a nutrition arm. Primary end points, assessed before random assignment and 4 and 13 months later, included mental functioning, physical functioning, and depressive symptoms. Four types of moderator variables were identified, including two sets reflecting psychosocial resources, specifically personality factors and factors related to the person's social environment, a set reflecting demographic variables, and a set reflecting treatment and disease variables (including comorbidities). Results Psychosocial factors were more likely to moderate treatment effects than were demographic and disease-related factors, but the moderating effects of these psychosocial factors were limited to patients receiving the nutrition intervention. Patients with lower psychosocial resources benefited from the nutrition intervention, whereas patients with a greater amount of psychosocial resources did not. Conclusion Future trials of this type should stratify by or select for the moderating variables identified here (ie, dispositional pessimism, unmitigated communion, and negative social interaction) to establish more firmly their role in responses to psychosocial interventions. Effort should also be made to collect data to inform the delivery of interventions to those who might benefit the most.

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