Weight, physical activity and breast cancer survival

McTiernan, Anne

doi:10.1017/s0029665118000010

Cited by 30 publications

(23 citation statements)

References 67 publications

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“…Although weight loss is recommended for obese breast cancer patients, the effects of weight loss on the risk for breast cancer recurrence are currently under investigation in long-term, clinical trials [93] . The effects of weight loss on the microenvironment of the breast are not well known but may impact breast cancer risk and recurrence.…”

Section: Discussionmentioning

confidence: 99%

Obesity-Activated Adipose-Derived Stromal Cells Promote Breast Cancer Growth and Invasion

et al. 2018

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Obese women diagnosed with breast cancer have an increased risk for metastasis, and the underlying mechanisms are not well established. Within the mammary gland, adipose-derived stromal cells (ASCs) are heterogeneous cells with the capacity to differentiate into multiple mesenchymal lineages. To study the effects of obesity on ASCs, mice were fed a control diet (CD) or high-fat diet (HFD) to induce obesity, and ASCs were isolated from the mammary glands of lean and obese mice. We observed that obesity increased ASCs proliferation, decreased differentiation potential, and upregulated expression of α-smooth muscle actin, a marker of activated fibroblasts, compared to ASCs from lean mice. To determine how ASCs from obese mice impacted tumor growth, we mixed ASCs isolated from CD- or HFD-fed mice with mammary tumor cells and injected them into the mammary glands of lean mice. Tumor cells mixed with ASCs from obese mice grew significantly larger tumors and had increased invasion into surrounding adipose tissue than tumor cells mixed with control ASCs. ASCs from obese mice demonstrated enhanced tumor cell invasion in culture, a phenotype associated with increased expression of insulin-like growth factor-1 (IGF-1) and abrogated by IGF-1 neutralizing antibodies. Weight loss induced in obese mice significantly decreased expression of IGF-1 from ASCs and reduced the ability of the ASCs to induce an invasive phenotype. Together, these results suggest that obesity enhances local invasion of breast cancer cells through increased expression of IGF-1 by mammary ASCs, and weight loss may reverse this tumor-promoting phenotype.

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Section: Discussionmentioning

confidence: 99%

Obesity-Activated Adipose-Derived Stromal Cells Promote Breast Cancer Growth and Invasion

et al. 2018

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“…SCPPs can meet patients’ information needs [3], improve communication with clinicians, and improve well-being [4]. In addition, SCPPs need to address healthy lifestyles as most cancer survivors tend to be overweight or obese and have sedentary lifestyles [5-7], particularly Latinos, [8] and strong observational evidence links these risk factors with poorer survival among breast cancer survivors [9]. Physical activity interventions, in particular, improve symptoms and health-related quality of life [10-12] and reduce the risk of recurrence and death among breast cancer survivors [13].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Mobile Phone App and Telephone Coaching Survivorship Care Planning Program Among Spanish-Speaking Breast Cancer Survivors

Nápoles¹,

Santoyo‐Olsson²,

Chacon³

et al. 2019

JMIR Cancer

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Background Spanish-speaking Latina breast cancer survivors experience disparities in knowledge of breast cancer survivorship care, psychosocial health, lifestyle risk factors, and symptoms compared with their white counterparts. Survivorship care planning programs (SCPPs) could help these women receive optimal follow-up care and manage their condition. Objective This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of a culturally and linguistically suitable SCPP called the Nuevo Amanecer (New Dawn) Survivorship Care Planning Program for Spanish-speaking breast cancer patients in public hospital settings, approaching the end of active treatment. Methods The 2-month intervention was delivered via a written bilingual survivorship care plan and booklet, Spanish-language mobile phone app with integrated activity tracker, and telephone coaching. This single-arm feasibility study used mixed methods to evaluate the intervention. Acceptability and feasibility were examined via tracking of implementation processes, debriefing interviews, and postintervention satisfaction surveys. Preliminary efficacy was assessed via baseline and 2-month interviews using structured surveys and pre- and postintervention average daily steps count based on activity tracker data. Primary outcomes were self-reported fatigue, health distress, knowledge of cancer survivorship care, and self-efficacy for managing cancer follow-up health care and self-care. Secondary outcomes were emotional well-being, depressive and somatic symptoms, and average daily steps. Results All women (n=23) were foreign-born with limited English proficiency; 13 (57%) had an elementary school education or less, 16 (70%) were of Mexican origin, and all had public health insurance. Coaching calls lasted on average 15 min each (SD 3.4). A total of 19 of 23 participants (83%) completed all 5 coaching calls. The majority (n=17; 81%) rated the overall quality of the app as “very good” or “excellent” (all rated it as at least “good”). Women checked their daily steps graph on the app between 4.2 to 5.9 times per week. Compared with baseline, postintervention fatigue (B=–.26; P= .02; Cohen d =0.4) and health distress levels (B=–.36; P= .01; Cohen d =0.3) were significantly lower and knowledge of recommended follow-up care and resources (B=.41; P= .03; Cohen d =0.5) and emotional well-being improved significantly (B=1.42; P= .02; Cohen d =0.3); self-efficacy for managing cancer follow-up care did not change. Average daily steps increased significantly from 6157 to 7469 (B=1311.8; P= .02; Cohen d =0.5). Conclusions We found preliminary evidence of program ...

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“…According to a systematic review, there was a strong association between insufficient physical activity and a decreased prognosis in patients with breast cancer [11]. Furthermore, physical activity interventions may alleviate psychological problems by exerting small-to-moderate beneficial effects on emotional distress and anxiety [12].…”

Section: Introductionmentioning

confidence: 99%

Mediating effects of depression on anxiety and leisure constraints in patients with breast cancer

2019

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BackgroundPatients with breast cancer often exhibit high levels of anxiety and depression and a considerable decrease in their ability to participate in leisure activities, which result in the long-term disruption of their daily lives. This study intended to explore the relationships among anxiety, leisure constraints, and depression and evaluate whether depression mediates the effects of anxiety on leisure constraints in patients with breast cancer.MethodThis prospective study included 106 patients with breast cancer. All the patients completed the Taiwanese version of the Hospital Anxiety and Depression Scale and Leisure constraints questionnaire. Path analysis was used to test the mediating role of depression.ResultsLeisure constraints, anxiety, and depression were positively interrelated and co-occurred in the patients. The accelerated bootstrapping confidence intervals of the indirect effect did not include zero (0.276–1.663). Moreover, depression completely mediated the effects of anxiety on leisure constraints in patients with earlier cancer stages but not in patients with advanced cancer stages.ConclusionsDepression is a crucial mechanism underlying the relationship between anxiety and leisure constraints in patients with breast cancer. Although many patients experience minimal disruption of activities and roles during survivorship, they are unable to perform functional activities and satisfactorily play their roles. This is the first study to explore leisure constraints in patients with breast cancer and investigate the mediating role of depression that underlies the relationship between anxiety and leisure constraints. The current findings are clinically crucial because they suggest the need to consider the simultaneous management of anxiety and depression for alleviating leisure constraints.

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Weight, physical activity and breast cancer survival

Cited by 30 publications

References 67 publications

Obesity-Activated Adipose-Derived Stromal Cells Promote Breast Cancer Growth and Invasion

Obesity-Activated Adipose-Derived Stromal Cells Promote Breast Cancer Growth and Invasion

Feasibility of a Mobile Phone App and Telephone Coaching Survivorship Care Planning Program Among Spanish-Speaking Breast Cancer Survivors

Mediating effects of depression on anxiety and leisure constraints in patients with breast cancer

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