Preliminary study on the effects of treatment for breast cancer: immunological markers as they relate to quality of life and neuropsychological performance

Abstract

Background: Immunological biomarkers were related to quality of life and neuropsychological performance in women recently diagnosed with breast cancer through the first six months of treatment. A comparison group of breast cancer survivors in remission were also evaluated. Method: Twenty women newly diagnosed with breast cancer and 26 breast cancer survivors at least a year after treatment were evaluated four times over a course of six to 8 months. The assessments included quality-of-life, emotional and spiritual well-being, sleep quality, computerized neuropsychological performance, and cytokine immunology biomarkers using flow cytometry. The principal immunological markers examined were the CD4+, CD8+, and CD16+ counts. Results: Although equivalent at enrollment, active treatment women reported higher anxiety, depression, poorer quality-of-life, and poorer processing speed and accuracy on memory, logical processes, and coding neuropsychological tasks. They also had significantly higher CD8+ and CD16+ cell count levels during treatment over the next six to eight months than comparison group women in remission. Women undergoing chemotherapy as well during treatment phase also had a significant decline in CD4+ counts. Higher percent CD8+ levels during treatment was associated with poorer quality of life and more depression, while higher CD4+ and CD8+ were associated with poorer neuropsychological memory and processing speed performance. Conclusion: Significant increases in CD8+ is a sensitive biomarker of a broad range of poorer quality-of-life and neurocognitive functioning outcomes during breast cancer treatment, especially in women undergoing chemotherapy. Quality of life should be monitored in breast cancer patients and psychosocial support made available as a standard of care.

Exploratory study of a screening measure for polycystic ovarian syndrome, quality of life assessment, and neuropsychological evaluation

“…Zung self-rating depression scale [26] Used by our group in a previous women's health study in this study setting pertaining to breast cancer treatment [27], this is a 20-item self-administered questionnaire that takes only a few minutes to complete. It includes a variety of statements associated with depressed moods and is a helpful tool to assess depression in individuals in a general medical setting [28].…”

“…The State-Trait Anxiety Inventory (STAI) is a 40item measure that looks at both state (in the moment" and trait (chronic) anxiety (Spielberger, 1977) [29]. This questionnaire was used by our group in a previous women's health study pertaining to breast cancer treatment [27]. This instrument has been used effectively to characterize anxiety in adolescent and adult women with PCOS [30,31].…”

“…Fatigue symptom inventory (FSI) [32][33][34] Originally developed for cancer patients and used by our group in a previous women's health study pertaining to breast cancer treatment, [27] this is a 14-item self-report measure for measuring the intensity, frequency, and impact of symptoms of fatigue on a woman's quality of life. Higher scores indicate more fatigue symptoms.…”

“…Bottomley social support scale (BSS) [35] This is a seven-item scale originally designed for cancer patients and used by our group in a previous women's health study pertaining to breast cancer treatmen [27]. This measure was adapted for the present study by removing specific references to "cancer."…”

“…Higher scores indicate a stronger spiritual QoL. This measure of spirituality was used previously by our group in a study pertaining to breast cancer treatment [27].…”