The physiological and psychological impact of adjuvant chemotherapy treatment in women with primary breast cancer

Abstract

Adjuvant chemotherapy treatment for primary breast cancer is a successful treatment protocol for prolonging disease-free and overall survival; however, it is associated with numerous physiological and psychological side effects which can affect an individual’s quality of life, disease prognosis, risk of recurrence and overall health. The 5-year survival rate for breast cancer in New Zealand is currently close to 85%, making the issue of survivorship particularly relevant.

The purpose of the current case series analysis was to examine the physiological and psychological impact of adjuvant chemotherapy treatment. Anthropometric variables, body composition, muscle quality, and psychological outcomes were measured in six women receiving adjuvant chemotherapy treatment for primary breast cancer; trends in antiemetic use, resting metabolic rate (RMR), dietary intake and physical activity were also examined throughout the study duration. Measurements were conducted immediately before the participant’s first chemotherapy treatment, at the end of their first treatment regimen and after their last treatment.

Given the nature of case series, descriptive statistics were conducted to assess group and individual changes in the outcomes during treatment. Mean weight gain throughout the study duration was 3.0 kg, with individual weight change ranging from -4.7 kg to 11.9 kg. Fat mass and percent body fat increased by 2.7 kg and 1.4%, respectively, and lean tissue mass (LTM) decreased by 0.1 kg. Increases in absolute, measured RMR (kcal/day) and RMR relative to LTM (kcal/kgLTM/day), and a decrease in RMR relative to total body weight (kcal/kg/day) were observed. Muscle quality, a factor not previously reported, decreased over time. Physical activity levels decreased throughout treatment; as did total energy intake. Adjuvant chemotherapy was also found to have profound effects on psychological outcomes, with decreased quality of life, body image impairment and increased fatigue levels reported throughout treatment.

The depth of information collected from each participant provides a comprehensive picture of the extent to which side effects associated with this treatment protocol affect individuals. The results of the current study lend themselves to support the need to develop strategies to avoid or minimise some of the adverse effects of adjuvant chemotherapy treatment for primary breast cancer.