Management of side effects during and post-treatment in breast cancer survivors

Abstract

Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are commonly experienced symptoms that share psychological and physical manifestations. One or more of these symptoms will affect nearly all patients at some point during their course of treatment or survivorship. These side effects are burdensome and reduce patients' quality of life well beyond their cancer diagnosis and associated care treatments. Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are likely to have multiple etiologies that make it difficult to identify the most effective method to manage them. In this review, we summarized the information on cancer-related fatigue, insomnia, and cancer-related cognitive impairment incidence and prevalence among breast cancer patients and survivors as well as recent research findings on pharmaceutical, psychological, and exercise interventions that have shown effectiveness in the treatment of these side effects. Our review revealed that most current pharmaceutical interventions tend to ameliorate symptoms only temporarily without addressing the underlying causes. Exercise and behavioral interventions are consistently more effective at managing chronic symptoms and possibly address an underlying etiology. Future research is needed to investigate effective interventions that can be delivered directly in clinic to a large portion of patients and survivors.

Relationships between self‐reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

“…Our findings revealed that PSQI Daytime Dysfunction, PSQI Efficiency, and PSQI Disturbance were the strongest predictors of FACT‐Cog PCI and are consistent with other studies linking sleep disturbance and daytime sleepiness to perceived attention ( rs = 0.32 to −0.64), and self‐reported sleep quality and daytime dysfunction, to PCI in BCS. Similarly, our findings support links between fatigue, a concept related to daytime functioning, and PCI that have been found in BCS . Additionally, significant relationship has been found between subjective sleep quality, daytime sleepiness, and cognitive complaints in older adults .…”

“…Similarly, our findings support links between fatigue, a concept related to daytime functioning, and PCI that have been found in BCS. 37 Additionally, significant relationship has been found between subjective sleep quality, daytime sleepiness, and cognitive complaints in older adults. 35…”

Symptom burden among older breast cancer survivors: The Thinking and Living With Cancer (TLC) study

“…We did find that being more physically active did reduce symptoms and improve well‐being. Lifestyle interventions, including exercise, reductions in sedentary time, yoga, cognitive retraining, and weight loss, have been shown to increase well‐being in other studies, so this remains an important topic for survivorship care visits …”

Low Serum Carotenoids Are Associated with Self-Reported Cognitive Dysfunction and Inflammatory Markers in Breast Cancer Survivors

“…With over 252,000 new breast cancer cases estimated in 2017 and a 90% five-year survival rate, the population of over 3.5 million U.S. breast cancer survivors (BCS) will continue to increase [ 1 , 2 ]. BCS live with many treatment-related side effects including cognitive dysfunction [ 3 ]. There is evidence that up to 75% of breast cancer patients experience cognitive decline during cancer treatment and that these impairments can persist up to twenty years following treatment completion [ 4 , 5 ].…”