Inflammation and Clinical Decline After Adjuvant Chemotherapy in Older Adults With Breast Cancer

[Hazelgreen]

Published in Oncology Journal Scan / Research · October 11, 2022

Older breast cancer survivors are at increased risk of clinical decline after adjuvant chemotherapy. This prospective study of women age ≥ 65 years with stage I-III breast cancer treated with chemotherapy aimed to evaluate whether inflammatory markers assessed before adjuvant chemotherapy are associated with chemotherapy-induced clinical decline in a population of fit older adults with breast cancer.

"Of the 295 robust women at T1 (Time 1), 76 (26%) experienced chemotherapy-induced decline in frailty status"

"In this cohort of older women with early breast cancer who were clinically fit before chemotherapy initiation, high IL-6 and CRP prechemotherapy (inflammatory markers) were associated with chemotherapy-induced decline in frailty status independent of sociodemographic and clinical risk factors. Further research is needed to examine whether inflammatory markers can inform more personalized approaches to treating older breast cancer survivors."

[8576]

Thanks Hazel for finding this study but my feeling is we are all different in many ways and it would be endless.

Cheers, June S.

[Hazelgreen in reply to 8576]

Sorry, June, I do not think, "ignorance is bliss"...

[8576 in reply to Hazelgreen]

Neither do I! But where is the answer in this. People smarter than you and I are testing their knowledge every day.

Cheers, June S.

[Hazelgreen in reply to 8576]

There is no specific answer for you or me. However, physicians would be well-advised in the future to test for these inflammatory markers in their patients (especially those over age 65) before prescribing adjuvant chemotherapy (there is no strong evidence that chemotherapy prevents recurrance in any case, but many oncologists do not seem to know this).

[LadyKatarina]

Thank you for posting. Yes, I have definitely experienced a decline after treatment. My oncologist thinks it is due to the accumulating cognitive loss in older women. I ended up stopping all systemic treatment for the past year and a half, and some cognition returned. These side effects are very serious, and if they can study new "markers" to help focus treatment, how helpful. I was dx de novo--so didn't even have any "IV chemo"--only the so called "targeted" Ai's and Ibrance for 3 to 4 years.. Thanks again for sharing. Kay

[Hazelgreen in reply to LadyKatarina]

Hi Kay,

I fully agree with you that the side effects for all systemic treatment can be very serious, and much worse than the original problem/disease. It seems to me that medical research needs to be done at a basic level to determine how and why bodies differ in their individual responses. Instead, we are all given the same dosages of strong medicines, which are then merely reduced in strength until they quit working. Despite the billions that well-meaning people have raised for cancer research, medical treatment of individuals is still "in the dark ages". Any fool could follow the current "standards of care" with the same results.

I think we are fortunate to be older with slow-growing cancers that may still be there whenever our hearts or other organs finally give out. Each of us has to decide for ourselves whether the risk that our cancers may grow faster without treatment is worth paying for the freedom from the side effects of the medications we are prescribed.

I apologize for this rant in advance.

Hugs,

Cindy

[LadyKatarina in reply to Hazelgreen]

Ha! I don't see this as a "rant"!! All is very true--and the oncology field needs so much more. The FDA is only now starting to test varying dose levels instead of a one size fits all. And that is very far from the individualized approach which the future may hold. It will be long time before they fully understand this/these disease called cancer. For now, it is the dark ages! In the meantime, keep posting new info! Kay

[Hazelgreen in reply to LadyKatarina]

Thanks for your understanding, Kay!

[8576 in reply to Hazelgreen]

I am beginning to understand your point of view as well. I wish you could work with my second opinion doctor in Newmarket, Ontario. She is brilliant. So when I run into these oncologists which go by the book, I have a phone consultation or visit with her. I agree, that these medicines are prescribed even with the side effects that are horrible.

Cheers, June S.

[jersey-jazz]

Here's to you, C. ! This is what I am all about. The drugs may save us but also, sometimes destroy parts of us as well. They need to be tailored to not just our cancers but to our individual bodies as well. I am a small person. Yet, I was on the same dosage of Letrozole as someone totally different in build than me. I had a strong heart with absolutely nothing wrong with it. Then, it became debilitated with that drug which, by the way, did nothing to fix the cancer. I am still on the same hobby horse about circulating tumor cell DNA which speaks to this topic of yours. Right after this, I will post it separately.

[Aquamoron]

Inflammation plays such a key role in all of this. The way bodies react to inflamation sucks energy away from healthy cell development and repair (at any age). I always read these studies with a grain of salt. 295 subjects in this study is a good start, but a small sample.

Thanks for giving us all something to think about, and to ‘ping’ our specialists to make sure they are current.

Personal note: I’m on a quest to find out more about phytoestrogens. Anyone have any gems of wisdom? My research has produced limited (and conflicting) results.

[Hazelgreen in reply to Aquamoron]

Actually, 295 is a good-sized sample, especially with the age restriction. If you check the original research studies supporting our use of the various CDK4/6 inhibitors, you'll find that none of them included such a large group of middle-aged subjects.

According to this secondary source (bcpp.org/resource/phytoestr..., scientific studies on phytoestrogens have indicated both extremes: "Phytoestrogens, especially when consumed regularly during childhood, have been linked to a decreased risk of breast cancer." and "In predominantly pre-menopausal women who were considered to be at high risk for breast cancer, isoflavone intake through diet actually increased growth of breast cells in the lab." You may want to check the many references to scientific studies given on the website for BCPP.

Regards,

Cindy

[Aquamoron]

Thanks Hazlegreen. Am researching more and will check those sites. I’m more looking for phytoestrogen and interruption of cell repair, in certain levels it is proving beneficial to BRCA patients. In my mind, it’s tied into the mRNA convo, disrupting ER+ cancer cells from replicating because it does not allow cancer to get an easy handle within cells to take over. I did find some studies, but not current findings (2003, 2008, etc) and only 1 study with BRCA 1 and 2 cases.

Maybe this is a stretch. But going Mediterranean Diet has increased my phytoestrogens. Recently, my estrogen count is up, but my CA is down. (No complaints, but again- odd.) My estrogen level should not move much at all since being in surgical menopause since 2015. With ER+ cancer it is a head scratcher. So I am on a quest, so to speak and shaking all the trees. If food is medicine then how can I make sure I’m getting the correct/right amount of good stuff from my nutritionist’s point of view and satisfy my actual metabolic needs to stabilize on my oncologists protocol? Again, quest and or rabbit-hole.

🤔

[Hazelgreen in reply to Aquamoron]

According to BCPP, "Phytoestrogens are plant compounds that are estrogen-like in their cellular actions." so , maybe, it is not surprising that your recent estrogen count is up...