Neuropathy and health behaviors in cancer survivors treated with chemotherapy (CT)

Abstract

Background:A substantial proportion of cancer survivors are expected to experience longterm treatment toxicity. In this study we focused on the prevalence of neuropathy 2 years after breast cancer diagnosis (dx) and possible associations with modifiable health behaviors. Method(s): Using a population based French cross-sectional study (VICAN 2), we included 877 patients (pts) with early breast and colorectal cancer treated with CT. Neuropathy at 2 years after dx, was categorized as frequent/very frequent vs. rare/absent as reported by patients. Multivariate regression examined associations of neuropathy with health behaviors (physical activity [PA], obesity at dx, weight gain, fruit and vegetables increase consumption, alcohol and smoking), adjusting by clinical (age, gender, comorbidities, diabetes, cancer type), and treatment variables (surgery, radiation and hormonal therapy). Association of neuropathy with physical and mental health assessed by SF12 scale and employment status at 2 years was also explored. Result(s): At 2 years after diagnosis, 36% of pts reported frequent or very frequent neuropathy, and 17% had gained weight (>=10% change in weight), 59% of pts either decreased PA or remain inactive, 12% consumed alcohol >=4/week and 22% were smokers. Factors significantly associated with increased risk of neuropathy included health behaviors such as change in PA since dx (decreased PA/remain inactive vs increased/maintained PA: odds ratio 1.40 [1.04-1.89]) and weight gain (>=10.0% weight vs stable: 1.58 [1.08-2.30]) and clinical factors such as diabetes (yes vs no: 3.87 [1.61- 9.31]). Pts with neuropathy had lower physical and mental scores on SF 12 scale when compared with pts without neuropathy (37 and 38 vs 43 and 41, respectively, P<0.001), and a higher rate of unemployment (28% vs 20%, P: 0.008). Conclusion(s): In this large cohort of cancer survivors treated with CT, neuropathy affects a substantial proportion of pts and is associated with worse physical, mental and social outcomes. In addition, we found that inactivity and weight gain were significantly associated with neuropathy. Health behaviors interventions focused on inactivity and weight gain can represent a potential opportunity to improve neuropathy and associated outcomes after cancer.