Friday, August 12, 2011

Breast Cancer News (8/12): Insomnia and anemia

Feeling tired? Insomnia and anemia are problems for many breast cancer patients, and both cause fatigue. Today we'll look at the latest breast cancer research on insomnia and anemia.

Insomnia in breast cancer patients and survivors

Three recent studies and a Reuters news story addressed insomnia in breast cancer patients and survivors. All may be found on the mastectomy page of the website.

Insomnia before and after surgery for early-stage cancer

An August 8 Journal of Clinical Oncology study from Canada periodically assessed insomnia in early-stage cancer patients from before surgery to 18 months later. Before surgery, insomnia levels were high. Women with breast or gynecologic cancers had higher rates than men with prostate cancer.

Over time, insomnia declined, but remained pervasive even 18 months later. The authors suggest that "[e]arly intervention strategies, such as cognitive-behavioral therapy, could prevent the problem from becoming more severe and chronic."

Carol Enderlin, a sleep researcher not involved in either study, told Reuters the findings indicate that sleep is "a really big problem for cancer patients." She advised patients to report changes in sleep before the problems become more severe. "When people are faced with stress, when they are faced with challenges, they do much better on a good night's sleep," she said. "It's very important, never more so than with cancer patients."

Insomnia, fatigue and depression after treatment for early breast cancer

Also on August 8, a Journal of Clinical Oncology study from UCLA assessed fatigue, sleep disturbance and depression among women who completed surgery, radiation and/or chemotherapy for early breast cancer. More than 60% reported "clinically significant problems with fatigue and sleep, and 25% reported elevated depressive symptoms." Women treated with chemotherapy reported higher levels of all symptoms. The authors associated the symptoms with elevated blood levels of markers of inflammation, suggesting that inflammatory signaling contributes to fatigue.

Insomnia may be due to arm and shoulder pain from breast cancer treatment

A June study from Norway in Sleep Medicine evaluated insomnia a median of 4 years and again 7 years after surgery and radiation for stage II/III breast cancer. Arm and shoulder pain at 4 years was significantly associated with insomnia at 4 and 7 years on simple analysis. In multivariate analysis, however, only the use of sleep aids remained associated with insomnia at 4 years. Only insomnia at 4 years remained associated with insomnia at 7 years. Nevertheless, the authors concluded that arm and shoulder problems, particularly pain, are factors to consider in breast cancer survivors with insomnia.

Anemia develops immediately after treatment for advanced cancer

One potential side effect of chemotherapy is anemia, a low red blood cell count. An August 3 study in Breast Cancer Research and Treatment analyzed the blood of advanced breast cancer patients one hour after chemotherapy with Adriamycin (doxorubicin) or Taxol (paclitaxel). Just one hour after chemotherapy, anemia and oxidative stress were already evident. The authors conclude that this is a new perspective on the aggravation of chronic anemia in women with advanced breast cancer.

Please check back Monday for the weekend breast cancer research news update. Until then, all the latest news and research for any breast cancer test or treatment option may be found on the website anytime.

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