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Relationships among psychoneurological symptoms and levels of C-reactive protein over 2 years in women with early-stage breast cancer

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Abstract

Purpose

The aim of the present study was to explore clusters of psychoneurological symptoms and inflammation (levels of C-reactive protein) over time in a cohort of women with early-stage breast cancer. Specifically, we examined the relationships among affective symptoms (depression, anxiety, fatigue, sleep disturbances, pain, and perceived stress), domains of cognitive performance, and levels of peripheral C-reactive over a period of 2 years.

Methods

This was a prospective, longitudinal study of 77 women diagnosed with early-stage breast cancer. Data collection, including symptom questionnaires, performance-based cognitive testing, and blood draws, took place at 5 time points: prior to initiating adjuvant chemotherapy, prior to the fourth chemotherapy treatment, and at 6, 12, and 24 months after the initiation of chemotherapy.

Results

Exploratory factor analysis with varimax orthogonal rotation was used to examine the covariance among symptoms at each visit. Using the factor scores and weighted sums, three clusters were identified: global cognition, affective symptoms, and cognitive efficiency. Peripheral levels of C-reactive protein were inversely correlated with the cognitive efficiency factor across time.

Conclusions

The findings suggest that objectively measured domains of cognitive function occur independently of other affective symptoms that are commonly reported by women with breast cancer in long-term survivorship. The cognitive efficiency symptom cluster may be amenable to interventions targeted to biological influences that reduce levels of C-reactive protein.

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Acknowledgments

The authors would like to thank Jamie Sturgill, PhD, and Julie Stillman for their expertise in performing the assays reported in the study.

Author information

Authors and Affiliations

  1. University of Connecticut School of Nursing, Storrs, CT, USA

    Angela Starkweather

  2. University of Florida College of Nursing, Gainesville, FL, USA

    Debra Lynch Kelly & Debra E. Lyon

  3. Virginia Commonwealth University School of Nursing, Richmond, VA, USA

    Leroy Thacker & Colleen K. Jackson-Cook

  4. Yale University, New Haven, CT, USA

    Michelle L. Wright

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  1. Angela Starkweather
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Corresponding author

Correspondence to Angela Starkweather.

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Conflicts of interest and source of funding

This research was supported by the National Institute of Nursing Research (Lyon/Jackson-Cook; MPI; R01 NR012667). Dr. Jackson-Cook (NIH/NIA R01AG037986) and Dr. A. Starkweather (R01 NR013932) are currently receiving grants. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research (NINR), the National Institute on Aging (NIA), or the National Institutes of Health (NIH). For the remaining authors, none were declared.

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Starkweather, A., Kelly, D.L., Thacker, L. et al. Relationships among psychoneurological symptoms and levels of C-reactive protein over 2 years in women with early-stage breast cancer. Support Care Cancer 25, 167–176 (2017). https://doi.org/10.1007/s00520-016-3400-2

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  • DOI: https://doi.org/10.1007/s00520-016-3400-2

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