Excess Body Weight and Cancer-Related Fatigue, Systemic Inflammation, and Serum Lipids in Breast Cancer Survivors

Abstract

Background

Cancer-related fatigue (CRF) is a common side effect impacting breast cancer survivors. Research points to a relationship between obesity and CRF in breast cancer survivors related to elevated systemic inflammation and metabolic alterations.

Methods

This cross-sectional study examined the relationship of obesity to CRF, inflammatory markers and serum lipids through a secondary analysis of a nationwide randomized controlled trial. Breast cancer survivors with CRF were categorized based on BMI category. Symptoms of CRF, inflammatory markers and serum fatty acids were assessed among groups.

Results

There were 105 breast cancer survivors in the analysis. BMI was positively associated with CRF based on MFSI General (p = 0.020; 95% C.I. 0.024, 0.273) and MFSI Physical (p = 0.013; 95% C.I. 0.035, 0.298) subscales. TNF-α (p = 0.007; 95% C.I. 0.007, 0.044), and IL-6 (p = 0.020; 95% C.I. 0.006, 0.073) were elevated in the obese. Monounsaturated fatty acid levels (p = 0.047; 95% C.I. 0.000, 0.053) and the omega-6 to omega-3 fatty acid ratio were associated with obesity (p = 0.047; 95% C.I. 0.002, 0.322).

Conclusions

Obese breast cancer survivors had greater levels of CRF, inflammatory markers and certain fatty acids. Inflammatory markers and fatty acids were not found to have any mediating or positive association with CRF variables in this analysis. NCT02352779.

Acknowledgments

We thank the participants of this study and all staff at the University of Rochester Cancer Center NCORP Research Base and our NCORP affiliate sites.. We also thank the staff of the Cancer Control Behavioral Medicine Research Unit and the Cancer Control and Psychoneuroimmunology Lab.

Disclosure Statement

The authors report no conflict of interest.

Ethics Approval and Consent to Participate

This study was approved by the Institutional Review Board of the University of Rochester. Informed consent was obtained from all participants. All mandatory laboratory health and safety procedures have been complied with in the course of conducting any experimental work reported in this paper.

Availability of Data and Materials

Clinical Trials registration number: NCT02352779

Authors’ Contributions

Conception and design: JEI, LJP. Data collection: LJP. Data analysis and interpretation: JEI, EC. Manuscript writing: JEI. Final approval of manuscript: All authors.

Additional information

Funding

This work was supported by NIH Grants R03-CA175599, UG1-CA189961, K07-CA168911, NCI T32CA102618 and R25-CA102618.