Impact of Obesity on Quality of Life, Psychological Distress, and Coping on Patients with Colon Cancer

Abstract

Background. Despite the causal relationship between obesity and colon cancer being firmly established the effect of obesity on the course of cancer calls for further elucidation. The objective was to assess differences in clinicalpathological and psychosocial variables between obese and non-obese individuals with colon cancer. Patients and Methods. Prospective, multicentric, observational study conducted from 2015-2018. The sample comprised patients with stage II-III, resected colon cancer about to initiate adjuvant chemotherapy with fluoropyrimidine in monotherapy or associated with oxaliplatin and grouped into non-obese (BMI <30kg/m 2) or obese (≥30kg/m 2). Subjects completed questionnaires appraising quality of life (EORTC-QLQ-C30), coping (M-MAC), psychological distress (BSI-18), perceived social support (MSPSS), personality (BFI-10), and pain (BPI). Toxicity, chemotherapy compliance, 12-month recurrence and mortality rate data were recorded. Results. Seventy-nine of the 402 individuals recruited (19.7%) were obese. Obese subjects exhibited more comorbidities (≥2 comorbidities, 46.8% vs 30.3%, p=0.001) and expressed feeling slightly more postoperative pain (small size-effect). There was more depression, greater helplessness, less perceived social support from friends, and greater extraversion among the obese versus non-obese subjects (all p<0.04). The non-obese group treated with fluoropyrimidine and oxaliplatin suffered more grade 3-4 hematological toxicity (p=0.035), whereas the obese had higher rates of treatment withdrawal (17.7% vs 7.7%, p=0.033) and more recurrences (10.1% vs 3.7%, p=0.025). No differences in sociodemographic, quality of life, or 12-month survival variables were detected. Conclusion. Obesity appears to affect how people confront cancer, as well as their tolerance to oncological treatment and relapse. The Oncologist 2021;9999:• • Implications for Practice: Obesity is a causal factor and affects prognosis in colorectal cancer. Obese patients displayed more comorbidities, more pain following cancer surgery, worse coping, more depression, and perceived less social support than the non-obese. Severe hematological toxicity was more frequent among non-obese

The Impact of Postoperative Complications on Short- and Long-Term Health-Related Quality of Life After Total Mesorectal Excision for Rectal Cancer

“…The differences in outcome between these studies might be subjected to the patient population, especially benign versus malignant, or the different questionnaires used in the studies. It might be related to the coping style which might differ between different patient populations, since patients with malignant diseases might be more resilient and cope differently with health deficits following postoperative complications, leading to a relative underestimation of the effect of complications on HRQoL 26,27 . Time points of measuring HRQoL were not equal in all studies, however, most studies measured HRQoL within the first 2 years after surgery.…”

Fatigue, Emotional Distress, and Illness Uncertainty in Patients with Metastatic Cancer: Results from the Prospective NEOETIC_SEOM Study

“…Fatigue was gauged using the three-item Health-related QoL (HRQoL) fatigue scale and the EORTC QoL QLQ-C30 questionnaire (version 3.0), which has been validated in Spanish [ 35 , 36 ]. The questionnaire consists of three simple questions: “Did you need rest?”, “Have you felt weak?”, and “Were you tired?”.…”

Body mass index–based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM

“…Those with a BMI > 35.0 kg/m 2 demonstrated a considerably increased risk of CRC recurrence and even mortality following combination chemotherapy with 5-FU, 5-FU plus leucovorin/levamisole regimens [ 58 ] . Patients with a greater BMI who received the drugs 5-FU and oxaliplatin had a higher rate of cessation, depression symptoms, and less social support [ 59 ]. A higher BMI was linked to peripheral neuropathy in patients with CRC receiving the oxaliplatin regimen combined with chemotherapy [ 60 ].…”

“…Higher risk of treatment withdrawal. Needs more social relationship support [ 59 ] Systemic therapy for liver mCRC > 25 Prevention of steatosis as well as liver fibrosis is needed [ 63 ] Rectal cancer Laparoscopic surgery for rectal cancer > 28 High difficulty of laparoscopic-assisted rectal resection [ 70 ] Primary full-thickness transanal excision for rectal cancer > 27 Take steps to prevent specific surgical site complications, including anastomotic complications and pelvic abscess formation requiring surgical drainage [ 71 ] Patients after rectal cancer surgery < 18.5 Poorer early and long-term prognosis [ 73 ] Male rectal cancer ≥ 25 Higher risk of a local recurrence [ 25 , 74 ] Chemoradiotherapy for locally advanced rectal cancer Loss > 7% 3-year overall survival rate significantly worse [ 22 ] Weight management for CRC Intermittent fasting - Only considered for use in clinical studies [ 94 – 96 ] Physical activity - Reduces all-cause mortality in all BMI classes, but requires attention to fatigue and cardiac function [ 100 , 106 ] Metformin ≥ 30 Greater benefit for patients undergoing 5-FU regimen for CRC, also recommended for use in patients with other c...…”