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Body changes in women undergoing chemotherapy for breast cancer Campbell, Kristin Leigh


Contrary to the general assumptions about the effects of cancer treatment, women undergoing adjuvant chemotherapy treatment for breast cancer tend to gain weight rather than lose it. This weight gain has implications for other health outcomes, disease-free survival, and psychosocial sequelae. Changes in body composition, resting metabolic rate, physical activity, dietary intake and menopausal status have all been associated with this weight gain. The purpose of this study was to better understand the mechanism of the weight gain by looking at the impact of possible body composition changes and changes in resting metabolic rate that occur with adjuvant chemotherapy treatment. Methods: Weight, resting metabolic rate, and menopausal status were measured prior to treatment, and with each cycle of chemotherapy in a group of five women (mean age 49.2±5.4 years; mean weight 75.2±17.8 kg) undergoing adjuvant chemotherapy for stage l-IIIA breast cancer. Body composition was measured prior to the start of chemotherapy and after the last cycle, using duel-energy x-ray absorptiometry. Results: One-way repeated measures ANOVA did not show any significant difference in weight or resting metabolic rate throughout treatment, however, plots of the mean effect showed an increase in weight over time and a decrease in resting metabolic rate during treatment, which returned to pre-treatment levels post treatment. However, the combined slopes of individual regression lines did not differ from zero. Average weight gain was 1.9 kg (range -2.71 to 6.81). No significant changes in body composition were found, however, a 2.5% increase in total percent body fat, and 3.5% increase in trunk percent body fat approached significance, along with a loss of left arm lean mass and gain in left leg lean mass. All participants became amenorrheic during treatment, except one that was postmenopausal prior to treatment. Conclusion: Participants tended to gain weight with treatment. The most striking association was the development of chemotherapy induced amenorrhea, which has been linked to changes associated with natural menopause, namely weight gain, a loss of lean mass, gain of fat mass, and change in fat distribution.

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