Fatigue and sleep quality are associated with changes in inflammatory markers in breast cancer patients undergoing chemotherapy.
ABSTRACT Fatigue and sleep disturbances are two of the most common and distressing symptoms reported by cancer patients. Fatigue and sleep are also correlated with each other. While fatigue has been reported to be associated with some inflammatory markers, data about the relationship between cancer-related sleep disturbances and inflammatory markers are limited. This study examined the relationship between fatigue and sleep, measured both subjectively and objectively, and inflammatory markers in a sample of breast cancer patients before and during chemotherapy. Fifty-three women with newly diagnosed stage I-III breast cancer scheduled to receive at least four 3-week cycles of chemotherapy participated in this longitudinal study. Fatigue was assessed with the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and objective sleep was measured with actigraphy. Three inflammatory markers were examined: Interleukin-6 (IL-6), Interleukin-1 receptor antagonist (IL-1RA) and C-reactive protein (CRP). Data were collected before (baseline) and during cycle 1 and cycle 4 of chemotherapy. Compared to baseline, more fatigue was reported, levels of IL-6 increased and IL-1RA decreased during chemotherapy. Reports of sleep quality remained poor. Mixed model analyses examining changes from baseline to each treatment time point revealed overall positive relationships between changes in total MFSI-SF scores and IL-6, between changes in total PSQI scores and IL-6 and IL-1RA, and between total wake time at night and CRP (all p's<0.05). These relationships suggest that cancer-related fatigue and sleep disturbances may share common underlying biochemical mechanisms.
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ABSTRACT: The ability to achieve sufficient restorative sleep is important in the maintenance of physical and mental health; however, disturbed sleep and insomnia symptoms are a common experience among women with breast cancer. In non-cancer populations, insufficient sleep quantity and quality has been associated with shortened telomere length (TL), a measure of accumulated cellular damage and human aging. This feasibility study compared TL in women previously diagnosed with breast cancer with clinically significant insomnia symptoms (n=70) to an age and BMI matched comparison group (n=70) of breast cancer survivors. Women with significant insomnia symptoms had higher levels of unemployment compared to women without insomnia. TL was positively skewed and shorter in the insomnia group (Mdn=6.000, S=1.000, SE= .287) than the control group (Mdn=6.195, S=-.269, SE=.287), however this was not significant (p = .29). Women with insomnia also reported significantly higher levels of depression (p < .001), anxiety (p < .001), and fatigue (p < .001). This study provides the first measure of effect size and variability of telomere length in women with breast cancer and highlights the need for larger sample sizes to investigate the impact of insomnia and co-morbid symptom distress on cellular aging.Rejuvenation Research 08/2014; · 2.92 Impact Factor
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ABSTRACT: Sleep disturbances are a prevalent and disabling problem for patients with cancer. Sleep disturbances are present throughout the cancer trajectory and especially prominent during oncological treatment. Previously sleep disturbances have primarily been quantified with subjective ratings scales. Actigraphy is an easy to use, non-invasive method for objective measurement of sleep. We systematically reviewed the literature for studies using actigraphy to measure sleeping habits of patients with cancer, undergoing oncological treatment. Our study furthermore reviewed studies with interventions designed to reduce sleep disturbances in the patient population. 19 studies were included in the final review of which 13 had a descriptive study design and 6 included some kind of intervention. The studies were primarily performed on patients with breast cancer undergoing chemotherapy. We found that sleep disturbances are prevalent and persistent in patients with cancer. The sleep disturbances seem to be aggravated by chemotherapy treatment and accumulate as the treatment continues. Sleep disturbances need further attention among clinicians working with patients with cancer.Sleep Medicine Reviews 01/2014; · 8.68 Impact Factor
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ABSTRACT: Cytokines are highly inducible, secretory proteins that mediate intercellular communication in the immune system. They are grouped into several protein families that are referred to as tumor necrosis factors, interleukins, interferons, and colony-stimulating factors. In recent years, it has become clear that some of these proteins as well as their receptors are produced in the organisms under physiological and pathological conditions. The exact initiation process of breast cancer is unknown, although several hypotheses have emerged. Inflammation has been proposed as an important player in tumor initiation, promotion, angiogenesis, and metastasis, all phenomena in which cytokines are prominent players. The data here suggest that cytokines play an important role in the regulation of both induction and protection in breast cancer. This knowledge could be fundamental for the proposal of new therapeutic approaches to particularly breast cancer and other cancer-related disorders.07/2014;