PURPOSE To investigate the effect of electro-acupuncture (EA) as a non-pharmacological intervention to prevent or reduce chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing chemotherapy of taxane. METHODS Women with stage I-III breast cancer scheduled to receive taxane therapy were randomized to receive a standardized protocol of 12 true or sham EA (SEA) weekly treatments concurrent with taxane treatment. Subjects completed the Brief Pain Inventory-Short Form (BPI-SF), Functional Assessment of Cancer Therapy-Taxane neurotoxicity subscale (FACT-NTX), and other assessments at baseline and weeks 6, 12, and 16. RESULTS A total of 180 subjects were screened, 63 enrolled and 48 completed week 16 assessments. Mean age was 50 with 25% white, 25% black, and 43% Hispanic; 52% had no prior chemotherapy. At week 12, both groups reported an increase in mean BPI-SF worst pain score, but no mean differences were found between groups (SEA 2.8 vs. EA 2.6, p=.86). By week 16, the SEA group returned to baseline, while the EA group continued to worsen (mean=1.7 in SEA vs. 3.40 in EA, p=.03). The increase in BPI-SF worst pain score was 1.62 points higher in the EA group than in the SEA group at week 16 (p=.04). CONCLUSIONS In a randomized, sham-controlled trial of EA for prevention of taxane-induced CIPN, there were no differences in pain or neuropathy between groups at week 12. Of concern, subjects on EA had a slower recovery than SEA subjects. Future studies should focus on EA for treatment as opposed to prevention of CIPN.

Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.

Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer. Patients and MethodsThis was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual crosssectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index $ 30 kg/m 2 for non-Asians and body mass index $ 27.5 kg/m 2 for Asians. ResultsAmong 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend , .001, both groups). Over this period, the estimated rate of annual increase in obesity prevalence was higher in women and men with a history of cancer compared with those without a history of cancer (all P for interaction , .001). The estimated rate of annual increase in obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P , .001). In subgroup analyses, populations with the highest rates of increasing obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks. ConclusionFrom 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity.

Purpose U.S. cancer survivors commonly use vitamins/minerals and complementary and alternative medicine (CAM). We compare use of vitamins/minerals and CAM by adult cancer survivors and cancer-free adults, and estimate annual out-of-pocket expenses. Methods Data on self-reported vitamin/mineral and CAM use in the past 12 months from the cross-sectional 2012 U.S. National Health Interview Survey were used to estimate prevalence of use and out-of-pocket expenditures. The cohort included adults with (n=2,977) and without (n=30,551) a self-reported cancer diagnosis. Results Approximately 79% of cancer survivors and 68% of cancer-free adults reported using ≥1 vitamins/minerals and/or CAM modality in the past year. Compared to cancer-free adults, cancer survivors were more likely to report use of vitamin/minerals (75% vs. 61%, P<0.001), herbal/non-vitamin supplements (24% vs. 19%, P<0.001), manipulative and body-based therapies (19% vs. 17%, P=0.03), and alternative medical systems (5% vs. 4%, P=0.04). Adult cancer survivors and cancer-free adults spent an annual estimated $6.7 billion and $52 billion out-of-pocket, respectively, on vitamins/minerals and CAM. Survivors spent 60% of the total on vitamins/minerals ($4 billion), 18% ($1.2 billion) on herbal/non-vitamin supplements, and 7% ($0.5 billion) on massage. Conclusions Compared with cancer-free adults, a higher proportion of cancer survivors report vitamin/mineral and CAM use. Cancer survivors, who accounted for 6.9% of the total population, accrued more than 11.4% of the annual out-of-pocket costs on vitamins/minerals and CAM spent by U.S. adults. Implications for Cancer Survivors Given the high use of vitamins/minerals and CAM in cancer survivors, studies are needed to analyze health outcomes and the cost:benefit ratio of such use.