Better quality of life in breast cancer patients is associated with healthier lifestyle choices

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One of the abstracts at the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life meeting presented unpublished data from the DietCompLyf study, which aims to assess possible links between plant phytoestrogen consumption and breast cancer recurrence and survival, as well as the analysis of quality of life outcomes. The research was carried out by Dr Ruth Swann, study co-ordinator at the University of Westminster, London, UK, and colleagues, supported by the National Cancer Research Network and funded by the charity Against Breast Cancer.

The latest analysis carried out by Dr Swann and her colleagues on nearly 3,000 breast cancer patients has produced preliminary data showing that patients with a higher quality of life (QoL) score had a lower body mass index (BMI) and exercised more than once a week. A higher quality of life was also associated with responsible levels of alcohol consumption and the less that the patient felt alone. Furthermore, patients who perceived that they had the practical and emotional support they needed following a breast cancer diagnosis also had a higher QoL score.

The primary aim of the DietCompLyf study is to determine if there is a correlation between phytoestrogen consumption and breast cancer recurrence and survival. The interest in phytoestrogens has arisen due to the oestrogenic properties of these compounds as well as the differences in phytoestrogen consumption between eastern and western diets. Further reports from the study will be available in late 2013.

Other data available from the study comes from a total of 3,159 breast cancer patients including their ethnicity, occupation, education, family history of breast cancer, reproductive history, physical activity, alcohol use, smoking and the use of complementary and alternative medicines. The patients are being followed-up for up to six years post-diagnosis and changes to diet and lifestyle are monitored annually. Diet and lifestyle is assessed by questionnaire, and blood and urine samples are collected at each study visit. This enables the measurement of phytoestrogens, other nutrients and biomarkers. Clinical information is also documented by hospital staff at every study visit.

Dr Swann said: “This is a truly comprehensive collection of data and the largest study of its type in the UK. It allows us to link quality of life scores with various lifestyle factors and assess changes in general health over time. It will be very interesting to analyse the data further for specific treatment types and other factors, and we hope to carry out this analysis soon.”

A standard EORTC Quality of Life Questionnaire (EORTC QLQ-C30) was among the tools used to collect data. Results available for all the patients included tumour size, grade, lymph node status, receptor status, treatment and lifestyle factors. 2,917 (92 percent) of the patients completed the quality of life questionnaire. The mean age at diagnosis of this sub-group of patients was 55 years, the majority were postmenopausal (66 percent), had a grade II tumour (47 percent) of less than 20mm diameter (51 percent). Most patients were oestrogen receptor positive (82 percent) and lymph node negative (62 percent). Preliminary analysis of the functional, symptom and global health scores from the EORTC QLQ-C30 showed significant association with age at diagnosis, lymph node status and chemotherapy treatment.

Dr Swann concluded: “If the cancer had spread to the armpit at the time of diagnosis and the patients had chemotherapy treatment then their quality of life scores were adversely affected 12 months post diagnosis. In addition, a higher BMI, lower levels of exercise and increased feelings of loneliness appeared to adversely affect quality of life.”

She adds: “In the next couple of years the DietCompLyf study dataset will provide an evidence-base on which to establish improvements in the dietary and lifestyle advice offered to patients following a breast cancer diagnosis. With increasing breast cancer survival rates it is becoming more important to understand the factors that influence post-treatment quality of life. This study goes a long way in helping us to do that.”

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