Inflammation and behavioral symptoms after breast cancer treatment: do fatigue, depression, and sleep disturbance share a common underlying mechanism?
|Title||Inflammation and behavioral symptoms after breast cancer treatment: do fatigue, depression, and sleep disturbance share a common underlying mechanism?|
|Publication Type||Journal Article|
|Year of Publication||2011|
|Authors||Bower JE, Ganz PA, Irwin MR, Kwan L, Breen EC, Cole SW|
|Journal||J Clin Oncol|
|Date Published||2011 Sep 10|
|Keywords||Adult, Aged, Antineoplastic Agents, Biomarkers, Breast Neoplasms, C-Reactive Protein, California, Combined Modality Therapy, Depression, Fatigue, Female, Humans, Inflammation, Interleukin 1 Receptor Antagonist Protein, Mastectomy, Middle Aged, Multivariate Analysis, Radiotherapy, Receptors, Tumor Necrosis Factor, Type II, Sleep Wake Disorders|
PURPOSE: Fatigue, depression, and sleep disturbance are common adverse effects of cancer treatment and frequently co-occur. However, the possibility that inflammatory processes may underlie this constellation of symptoms has not been examined.
PATIENTS AND METHODS: Women (N = 103) who had recently finished primary treatment (ie, surgery, radiation, chemotherapy) for early-stage breast cancer completed self-report scales and provided blood samples for determination of plasma levels of inflammatory markers: soluble tumor necrosis factor (TNF) receptor II (sTNF-RII), interleukin-1 receptor antagonist, and C-reactive protein.
RESULTS: Symptoms were elevated at the end of treatment; greater than 60% of participants reported clinically significant problems with fatigue and sleep, and 25% reported elevated depressive symptoms. Women treated with chemotherapy endorsed higher levels of all symptoms and also had higher plasma levels of sTNF-RII than women who did not receive chemotherapy (all P < .05). Fatigue was positively associated with sTNF-RII, particularly in the chemotherapy-treated group (P < .05). Depressive symptoms and sleep problems were correlated with fatigue but not with inflammatory markers.
CONCLUSION: This study confirms high rates of behavioral symptoms in breast cancer survivors, particularly those treated with chemotherapy, and indicates a role for TNF-α signaling as a contributor to postchemotherapy fatigue. Results also suggest that fatigue, sleep disturbance, and depression may stem from distinct biologic processes in post-treatment survivors, with inflammatory signaling contributing relatively specifically to fatigue.
|Alternate Journal||J. Clin. Oncol.|
|PubMed Central ID||PMC3179252|
|Grant List||P30 AG028748 / AG / NIA NIH HHS / United States |
P30-AG028748 / AG / NIA NIH HHS / United States
R01-CA10950 / CA / NCI NIH HHS / United States
UL1 RR033176 / RR / NCRR NIH HHS / United States
UL1 TR000124 / TR / NCATS NIH HHS / United States