Top

Published in:

01-09-2015

The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry

Authors: Pauline A. J. Vissers, Floortje Mols, Melissa S. Y. Thong, Frans Pouwer, Gerard Vreugdenhil, Lonneke V. van de Poll-Franse

Published in: Journal of Cancer Survivorship | Issue 3/2015

Abstract

Purpose

This study assessed differences in neuropathic symptoms between colorectal cancer (CRC) patients with and without diabetes. Moreover, we aimed to explore whether neuropathic symptoms could be explained by the receipt of chemotherapy as it was previously shown that cancer patients with diabetes less often receive chemotherapy.

Methods

Data from a cross-sectional study among CRC patients (2–11 years after diagnosis) was used. Data were collected by the Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES) registry which is linked to clinical data from the population-based Eindhoven Cancer Registry. Diabetes status was self-reported and neuropathic symptoms were measured with the European Organization for Research and Treatment of Cancer quality of life questionnaire–chemotherapy-induced peripheral neuropathy 20 (EORTC QLQ-CIPN20).

Results

Two hundred eighteen CRC patients with diabetes were matched on age and sex to 975 CRC patients without diabetes. After adjustments for cancer treatment including chemotherapy and other covariates, logistic regression models showed that CRC patients with diabetes experienced more mild to severe neuropathic symptoms, including tingling fingers or hands (odds ratio (OR) = 1.40; 95 % confidence interval (CI) 1.00–1.94), tingling toes or feet (OR = 1.47; 95 % CI 1.04–2.07), numbness in toes or feet (OR = 1.83; 95 % CI 1.28–2.62), and erection problems among men (OR = 1.83; 95 % CI 1.11–3.03) as compared to CRC patients without diabetes. No differences in cancer treatment were found between CRC patients with and without diabetes.

Conclusion

CRC patients with diabetes experienced more neuropathic symptoms, regardless of cancer treatment, suggesting that diabetes itself rather than treatment with chemotherapy results in more neuropathic symptoms among cancer patients with diabetes compared to those without.

Implications for Cancer Survivors

Up to 39 % of cancer survivors might expect mainly mild, neuropathic symptoms, with more symptoms among patients with co-occurring diabetes.

Parekh AK, Goodman RA, Gordon C, Koh HK. Managing multiple chronic conditions: a strategic framework for improving health outcomes and quality of life. Public Health Rep. 2011;126(4):460–71.PubMedCentralPubMed

Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4):430–9. doi:10.1016/j.arr.2011.03.003.CrossRefPubMed

World Health Organization. Global status report on noncommunicable diseases. Geneva: World Health Organization; 2011.

Parkin DM, Bray F, Ferlay J, Pisani P. Global Cancer Statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108. doi:10.3322/canjclin.55.2.74.CrossRefPubMed

Huxley RR, Ansary-Moghaddam A, Clifton P, Czernichow S, Parr CL, Woodward M. The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence. Int J Cancer. 2009;125(1):171–80. doi:10.1002/ijc.24343.CrossRefPubMed

van Dam RM. Review: The epidemiology of lifestyle and risk for type 2 diabetes. Eur J Epidemiol. 2003;18(12):1115–26. doi:10.1023/B:EJEP.0000006612.70245.24.PubMed

Janssen-Heijnen MLG, Houterman S, Lemmens VEPP, Louwman MWJ, Maas HAAM, Coebergh JWW. Prognostic impact of increasing age and co-morbidity in cancer patients: A population-based approach. Crit Rev Oncol Hematol. 2005;55(3):231–40. doi:10.1016/j.critrevonc.2005.04.008.CrossRefPubMed

Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–49. doi:10.1016/j.diabres.2013.11.002.CrossRefPubMed

van de Poll-Franse LV, Houterman S, Janssen-Heijnen ML, Dercksen MW, Coebergh JW, Haak HR. Less aggressive treatment and worse overall survival in cancer patients with diabetes: a large population based analysis. Int J Cancer. 2007;120(9):1986–92. doi:10.1002/ijc.22532.CrossRefPubMed

10.

Stein K, Snyder C, Barone B, Yeh H-C, Peairs K, Derr R, et al. Colorectal cancer outcomes, recurrence, and complications in persons with and without diabetes mellitus: a systematic review and Meta-Analysis. Dig Dis Sci. 2010;55(7):1839–51. doi:10.1007/s10620-009-0944-8.PubMedCentralCrossRefPubMed

11.

Srokowski TP, Fang S, Hortobagyi GN, Giordano SH. Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. J Clin Oncol. 2009;27(13):2170–6. doi:10.1200/jco.2008.17.5935.PubMedCentralCrossRefPubMed

12.

Nurgalieva Z, Xia R, Liu C-C, Burau K, Hardy D, Du XL. Risk of chemotherapy-induced peripheral neuropathy in large population-based cohorts of elderly patients with breast, ovarian, and lung cancer. Am J Ther. 2010;17(2):148–58. doi:10.1097/MJT.0b013e3181a3e50b.CrossRefPubMed

13.

de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000;18(16):2938–47.PubMed

14.

Land SR, Kopec JA, Cecchini RS, Ganz PA, Wieand HS, Colangelo LH, et al. Neurotoxicity From oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: NSABP C-07. J Clin Oncol. 2007;25(16):2205–11. doi:10.1200/jco.2006.08.6652.CrossRefPubMed

15.

Park SB, Lin CS, Krishnan AV, Goldstein D, Friedlander ML, Kiernan MC. Long-term neuropathy after oxaliplatin treatment: challenging the dictum of reversibility. Oncologist. 2011;16(5):708–16. doi:10.1634/theoncologist. 2010-0248.PubMedCentralCrossRefPubMed

16.

Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV. Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol. 2013;31(21):2699–707. doi:10.1200/JCO.2013.49.1514.CrossRefPubMed

17.

Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care. 2011;34(10):2220–4. doi:10.2337/dc11-1108.PubMedCentralCrossRefPubMed

18.

Candrilli SD, Davis KL, Kan HJ, Lucero MA, Rousculp MD. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complicat. 2007;21(5):306–14. doi:10.1016/j.jdiacomp.2006.08.002.CrossRefPubMed

19.

Gregg EW, Sorlie P, Paulose-Ram R, Gu Q, Eberhardt MS, Wolz M, et al. Prevalence of lower-extremity disease in the US adult population > =40 years of age with and without diabetes: 1999-2000 national health and nutrition examination survey. Diabetes Care. 2004;27(7):1591–7.CrossRefPubMed

20.

Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012;11(6):521–34. doi:10.1016/S1474-4422(12)70065-0.PubMedCentralCrossRefPubMed

21.

van Schie CHM. Neuropathy: mobility and quality of life. Diabetes Metab Res Rev. 2008;24(S1):S45–51. doi:10.1002/dmrr.856.CrossRefPubMed

22.

Bruun C, Siersma V, Guassora AD, Holstein P, de Fine ON. Amputations and foot ulcers in patients newly diagnosed with Type 2 diabetes mellitus and observed for 19 years. The role of age, gender and co-morbidity. Diabet Med. 2013;30(8):964–72. doi:10.1111/dme.12196.

23.

Boulton AJM, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. The Lancet.366(9498):1719-24. doi: 10.1016/S0140-6736(05)67698-2

24.

van de Poll-Franse LV, Horevoorts N, van Eenbergen M, Denollet J, Roukema JA, Aaronson NK, et al. The Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship registry: scope, rationale and design of an infrastructure for the study of physical and psychosocial outcomes in cancer survivorship cohorts. Eur J Cancer. 2011;47(14):2188–94. doi:10.1016/j.ejca.2011.04.034.CrossRefPubMed

25.

Coebergh JWW, Janssen-Heijnen MLG, Louwman WJ, Voogd AC. Cancer incidence and survival in the south of the Netherlands, 1955-1999 & incidence in the north of Belgium, 1996-1998 [CD-ROM]. Eindhoven: Comprehensive Cancer Centre South (IKZ); 2001.

26.

Mols F, Denollet J, Kaptein AA, Reemst PH, Thong MS. The association between Type D personality and illness perceptions in colorectal cancer survivors: a study from the population-based PROFILES registry. J Psychosom Res. 2012;73(3):232–9. doi:10.1016/j.jpsychores.2012.07.004.CrossRefPubMed

27.

Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49(2):156–63. doi:10.1002/art.10993.CrossRefPubMed

28.

Postma TJ, Aaronson NK, Heimans JJ, Muller MJ, Hildebrand JG, Delattre JY, et al. The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer. 2005;41(8):1135–9. doi:10.1016/j.ejca.2005.02.012.CrossRefPubMed

29.

Ramanathan RK, Rothenberg ML, de Gramont A, Tournigand C, Goldberg RM, Gupta S, et al. Incidence and evolution of oxaliplatin-induced peripheral sensory neuropathy in diabetic patients with colorectal cancer: a pooled analysis of three phase III studies. Ann Oncol. 2010;21(4):754–8. doi:10.1093/annonc/mdp509.CrossRefPubMed

30.

Schneider BP, Zhao F, Wang M, Stearns V, Martino S, Jones V, et al. Neuropathy is not associated with clinical outcomes in patients receiving adjuvant taxane-containing therapy for operable breast cancer. J Clin Oncol. 2012;30(25):3051–7. doi:10.1200/JCO.2011.39.8446.PubMedCentralCrossRefPubMed

31.

Brouwers EE, Huitema AD, Boogerd W, Beijnen JH, Schellens JH. Persistent neuropathy after treatment with cisplatin and oxaliplatin. Acta Oncol. 2009;48(6):832–41. doi:10.1080/02841860902806609.CrossRefPubMed

32.

Dimopoulos MA, Mateos MV, Richardson PG, Schlag R, Khuageva NK, Shpilberg O, et al. Risk factors for, and reversibility of, peripheral neuropathy associated with bortezomib-melphalan-prednisone in newly diagnosed patients with multiple myeloma: subanalysis of the phase 3 VISTA study. Eur J Haematol. 2011;86(1):23–31. doi:10.1111/j.1600-0609.2010.01533.x.CrossRefPubMed

33.

Vincenzi B, Frezza AM, Schiavon G, Spoto C, Silvestris N, Addeo R, et al. Identification of clinical predictive factors of oxaliplatin-induced chronic peripheral neuropathy in colorectal cancer patients treated with adjuvant Folfox IV. Support Care Cancer. 2013;21(5):1313–9. doi:10.1007/s00520-012-1667-5.CrossRefPubMed

34.

Uwah AN, Ackler J, Leighton Jr JC, Pomerantz S, Tester W. The effect of diabetes on oxaliplatin-induced peripheral neuropathy. Clin Colorectal Cancer. 2012;11(4):275–9. doi:10.1016/j.clcc.2012.05.002.CrossRefPubMed

35.

Zanders MMJ, van Steenbergen LN, Haak HR, Rutten HJT, Pruijt JFM, Poortmans PMP, et al. Diminishing differences in treatment between patients with colorectal cancer with and without diabetes: a population-based study. Diabet Med. 2013;30(10):1181–8. doi:10.1111/dme.12253.CrossRefPubMed

Title: The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry
Authors: Pauline A. J. Vissers
Floortje Mols
Melissa S. Y. Thong
Frans Pouwer
Gerard Vreugdenhil
Lonneke V. van de Poll-Franse
Publication date: 01-09-2015
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 3/2015
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-015-0429-z

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Implications for Cancer Survivors

Please log in to get access to this content

Other articles of this Issue 3/2015

Accelerometer-assessed physical activity and sedentary time among colon cancer survivors: associations with psychological health outcomes

Follow-up patterns of cancer survivors: a survey of Canadian radiation oncologists

Validation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire classification coding system using accelerometer assessment among breast cancer survivors

The experience of cognitive change in women with breast cancer following chemotherapy

Group medical consultations in the follow-up of breast cancer: a randomized feasibility study

An evaluation of cancer survivorship activities across national comprehensive cancer control programs

Keynote webinar | Spotlight on antibody–drug conjugates in cancer