Nutritional Intervention Contributes to the Improvement of Symptoms Related to Quality of Life in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial

Abstract

During breast cancer treatment, worsening quality of life (QoL) and the presence of toxicities are common, but healthy eating practices are associated with better clinical results. Thus, this study aims to evaluate the effect of a nutritional intervention on QoL and on gastrointestinal and hematological toxicities resulting from chemotherapy in women with breast cancer. A randomized clinical trial was performed at the beginning of neoadjuvant chemotherapy treatment for women with breast cancer. All participants received nutritional advice on healthy eating practices, but only the intervention group (IG) received an individualized diet plan. The study enrolled 34 women, 19 in the IG and 15 in the control group (CG). During the study, the CG significantly presented a reduction (from 21.6 ± 5.9 kg to 18.8 ± 4.0 kg, p = 0.009) in handgrip strength (HGS), while the IG did not present changes in this variable. Regarding QoL, the IG preserved the role function during treatment and presented better results for nausea/vomiting and loss of appetite compared to the CG. In gastrointestinal and hematological toxicities, the IG had lower frequencies of leukopenia and abdominal pain. The nutritional intervention preserved the role function of QoL and HGS, reduced the occurrence of nausea/vomiting, loss of appetite and the frequency of leukopenia and abdominal pain.

Qualidade de vida e estado nutricional de pacientes diagnosticadas com câncer de mama

“…Durante o tratamento quimioterápico de mulheres com câncer de mama é comum também ocorrerem alterações na mucosa do trato gastrointestinal e dificuldades na mastigação e deglutição, além de náusea e vômitos pré e pós-prandiais (35) . Sintomas que influenciam negativamente no estado nutricional e na qualidade de vida da paciente, particularmente nos aspectos relacionados às características físicas e emocionais (36) .…”

“…Da mesma maneira, intervenção nutricional durante os três primeiros ciclos de quimioterapia neoadjuvante em mulheres com câncer de mama apresentou-se como capaz de preservar a qualidade de vida, diminuindo a ocorrência de náuseas, vômitos e perda de apetite durante o tratamento. Esses achados reforçam a importância das intervenções nutricionais durante os tratamentos quimioterápicos a fim de minimizar possíveis impactos nutricionais, consequentes involuções clínicas durante a terapia ou mesmo a interrupção do tratamento (35) .…”

Ernährungsmedizinischer Bedarf und reale Versorgung von Brustkrebspatientinnen

“…Die regelhafte Integration einer qualifizierten Ernährungsberatung in die Betreuung von Brustkrebspatientinnen würde nicht nur ein subjektives Bedürfnis der Betroffenen adressieren, sondern damit könnten kritische Interaktionen von NEM mit der onkologischen Medikation verhindert, unerwünschte Wirkungen der Therapie reduziert und die Lebensqualität und Prognose der Brustkrebspatientinnen verbessert werden 31 32 33 34 . Die strukturierte Ernährungsberatung aller Brustkrebspatientinnen bereits ab dem Zeitpunkt der Diagnose entspräche außerdem den aktuellen Leitlinienempfehlungen 8 24 .…”

Development of the Breast Cancer Survivors Symptom Checklist for Use in Follow-Up Multidisciplinary Appointments

“…It has been suggested that worsening QoL might be related to worsened prognosis and an increase in the risk of recurrence. 3 …”

“…It has been suggested that worsening QoL might be related to worsened prognosis and an increase in the risk of recurrence. 3 Over the past decades, research has shown that breast cancer and its treatment have a significant emotional and social impact on patients, 4 their QoL 5,6 as well as their capacity for work. [7][8][9] Many survivors experience prolonged adverse physical, cognitive, and psychological effects.…”