Breast Cancer Female
Conditions
Brief summary
Breast cancer (BC) is the most common malignant disease, which is fifth leading cause of cancer mortality worldwide. Poor nutritional status is one of the common physical symptoms found among cancer patients, in which it is caused by both cancer disease state and its oncology treatment regimens used. Cancer patients develop a tumor-associated malnutrition characterized by an insufficient supply of macro- and micronutrients and systemic chemotherapy treatment that could significantly affecting the nutritional status of these patients by its side effects associated with chemotherapy that may lead to many medical complications that often requires hospitalization and death. An adequate nutritional intervention can have a beneficial impact on the disease condition and also the progress of the disease, as an integral part of adjuvant therapy on cancer care. Numerous studies had shown that the use of EPA and DHA are safe (absence of cardiotoxic effects) and effective in reducing the common chemotherapy-related side effects, such as bone density loss, peripheral neuropathy and weight gain. The question remains arises to whether administration of both vitamin D and omega-3 fatty acids supplementations could be used as important nutritional strategy during the active oncology treatment in breast cancer patients. In Palestine, nutritional intervention strategies are poorly evaluated in the oncology setting especially among patients undergoing chemotherapy. Suitable and proper nutritional interventions among breast cancer patients during active oncology treatments could help to improve nutritional status, decrease mortality and improve quality of life among these subjects. Hence, the present study is formulated to assess the effect of combined omega-3 fatty acid and vitamin D supplementation on the nutritional status, quality of life and blood inflammatory markers among breast cancer women undergoing chemotherapy treatment in the Gaza Strip, Palestine.
Detailed description
An adequate nutritional intervention can have a beneficial impacts on the disease condition and also the progress of the disease, as an integral part of adjuvant therapy on cancer care. Numerous clinical and epidemiological studies had found that vitamin D deficiency is common nutritional disorder in BC patients and that significantly associated with a negative prognostic factor, in which some have reported a positive effect of combining vitamin D or its analogues as an adjuvant therapy, together with a variety of chemotherapeutic factors used during oncology treatments. Moreover, combination of vitamin D and omega-3 fatty acids may provide a new complementary treatment by decreasing inflammatory biomarkers and resistance to cancer treatment in patients with BC. The question remains whether vitamin D and omega-3 fatty acids co-supplementation would actually be useful after diagnosis of BC. So, the aim of this study is to investigate the effects of vitamin D and omega-3 fatty acids co-supplementation on inflammatory biomarkers, and nutritional status in patients with BC.
Interventions
DIETARY_SUPPLEMENTOmega-3 FA
Two capsules of 1000mg fish oil daily (Each soft gel capsule contains 180mg EPA and 120 mg DHA)
DIETARY_SUPPLEMENTVitamin D
one capsule of vitamin D3 weekly (one D3 capsule contains 50,000 IU)
COMBINATION_PRODUCTCombined Omega-3 and Vitamin D Supplementation
Two capsules of 1000mg fish oil daily (Each soft gel capsule contains 180mg EPA and 120 mg DHA) and one capsule of vitamin D3 weekly (one D3 capsule contains 50,000 IU)
Sponsors
Universiti Sains Malaysia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Masking description
All eligible participants will be randomly selected and included in either one of these four (4) experimental groups (arms).The participants for each experimental will matched and stratified based on age group (± 5 years), menopausal status and BMI status (± 2 kg/m2). Each participant will be randomly allocated into four groups, based on their age, menopausal status and BMI status to ensure the standardization of general characteristics of study participants included in the study as a baseline data.
Intervention model description
An open-label randomized clinical trial of breast cancer women that are undergoing chemotherapy treatment for total duration of 2 months (approximately 9 weeks in total), in which participants will be randomly selected and included in either one of these four (4) experimental groups (arms).
Eligibility
Sex/Gender
FEMALE
Age
19 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
* Females who have been newly diagnosed with the breast cancer of stage I, II and III * Patients with following clinical diagnosis of breast cancer such as lymph node positive +ve, hormonal receptor negative -ve and human epidermal growth factor receptor 2 (HER2) negative -ve * Patient will receive her first chemotherapy treatment with Adriamycin + Cytoxan (AC) for a total of four cycle (each cycle will be carried-out every 3 weeks (21 days)
Exclusion criteria
* Participants who had already undertaken her chemotherapy previously, and/or other oncology treatments such as hormonal or radiation oncology therapy * Patients with recurrent breast cancer, patients with other chronic disease conditions such as renal disease and under dialysis, HIV, malabsorption disorder diseases, autoimmune diseases, diabetes, hypertension, hepatic, parathyroid, and gastrointestinal disorders. * Patients who have reported any allergy condition to fish and/or fish products * Pregnant women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of Nutritional Status Assessed by body weight levels | Change from baseline weight in kg at 2 months | Body weight will be measured in kilograms |
| Change of Muscle Mass Status | Change from Baseline calf circumference in cm at 2 months | Muscle mass status will be assessed by calf circumference levels in cm. Higher values of calf circumference is indicative of greater lean mass. |
| Change of Nutritional Status Condition, as assessed by the Patient-Generated Subjective Global Assessment PG-SGA | Change from Baseline Nutritional Status Condition in category of well-nourished, moderately malnourished or severely malnourished at 2 months | The PG-SGA will be based four components such as questions related to body weight status (scored 0-5), food intake (score 0-4); symptoms affecting oral food intake (scored 0-23), and lastly questions on daily activities and function, in which the degree of malnutrition of patients will be classified as (A) well-nourished; (B) moderately malnourished; or (C) severely malnourished. |
| Change of Total Scale and Single-item measures Scores derived from the Quality of life questionnaire (QLQ C-30) assessment | Change from Baseline total scales and single-item measures scores (0 to 100 scores) at 2 months | The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) assessment of 30 questions to measure cancer patients' physical, psychological and social functions. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the patient), while higher scores on the symptom and single-item scales indicate a higher level of symptoms (i.e. a worse state of the patient). |
| Change of Blood inflammatory markers of blood TNF-α levels | Change from baseline TNF-α levels in pg/mL at 2 months | Blood concentration of TNF-α levels will be measured in unit pg/mL. |
| Change of Blood inflammatory markers of blood CRP levels | Change from baseline CRP levels in nmol/L at 2 months | Blood concentration of CRP levels will be measured in nmol/L |
| Change of Nutritional status, as assessed by Body Mass Index | Change from Baseline BMI at 2 months | Body weight in kilograms and height in meters will be combined to report BMI in kg/m\^2 |
| Change of body weight | Change from Baseline Weight in kg at 2 months | Body weight will be measured in kilograms |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of Dietary Fat Intakes | Change from Baseline dietary fat intakes in grams at 2 months | Habitual dietary nutrients intake will be assessed by mean fat intakes in grams |
| Change of Dietary Protein Intakes | Change from Baseline dietary Protein intakes in grams at 2 months | Habitual dietary protein intakes will be assessed by mean protein intakes in grams |
| Change of Dietary Vitamin D intakes | Change from Baseline Dietary Vitamin D Intakes in microgram at 2 months | Habitual dietary nutrients intake will be assessed by mean vitamin D intakes in micrograms |
| Lifestyle physical activity status | Change from Baseline Physical Activity Status (inactive, minimally active or active physical activity status) at 2 months | A short form of the international physical activity questionnaire (IPAQ) will be used to assess the physical activity levels of the study participants, in which three different category groups of inactive, minimally active and active will be categorised. |
| Change of Dietary Energy Intakes | Change from Baseline dietary energy intakes in kcal at 2 months | Habitual dietary nutrients intake will be assessed by mean energy intakes in kcal |
Countries
Palestinian Territories
Outcome results
None listed