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Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications.

Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy. Department of Clinical Medicine and Surgery, Federico II University, 80131 Napoli, Italy. Department of Biomedical and Biotechnological Sciences Oncologic, Clinical and General Pathology Section, University of Catania, 95131 Catania, Italy. Cannizzaro Hospital, 95126 Catania, Italy. Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, 33081 Aviano, Italy. School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney 2006, Australia. Laboratory Medicine Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy. Clinica Mediterranea, 80122 Napoli, Italy. Division of Breast Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy. Rehabilitation Medicine Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy. Clinica Villa Fiorita, Aversa 81031, Italy. Immunopathology and Cancer Biomarkers Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, 33081 Aviano, Italy. Ospedale San Vincenzo, 98039 Taormina, Italy. Ospedale Evangelico Betania, 80147 Napoli, Italy. Rheumatology Unit, University of Verona, 37129 Verona, Italy. Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, ON M5S, Canada. Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, ON M5B 1T8, Canada. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, ON M5B 1T8, Canada. Scientific Directorate, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy.

Nutrients. 2020;(1)
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Abstract

Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), constipation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.

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MeSH terms : Cancer Survivors