Endocrine Abstracts (2008) 16 P457

Fatigue in breast cancer patients during chemotherapy: correlation with neuromuscular dysfunction and IGF-1 plasma levels

Roberto Baldelli1, Alberto Pietrangeli2, Giovanni Cigliana3, Alessandra Fabi4, Francesco Cognetti4, Patrizia Pugliese5 & Marialuisa Appetecchia1


1Unit of Endocrinology, Rome, Italy; 2Division of Neurology, Rome, Italy; 3Laboratory of Clinical Pathology, Rome, Italy; 4Division of Medical Oncology, Rome, Italy; 5Unit of Psychology, Regina Elena Cancer Institute, Rome, Italy.


Introduction: Adult growth hormone deficiency is associated with fatigue, tiredness and myalgias. The same clinical pattern can often be present in oncological patients during chemotherapy and follow up.

Aim of the study: To conduct an extensive neuromuscular investigation of patients with breast cancer (BC), treated with taxol, in an attempt to explain their neuromuscular symptoms, eleven pre-menopausal patients with BC underwent a prospective protocol, including hormonal examination and a neurophysiological study that comprised electromyogram (EMG) of sural nerve. All patients were even evaluated for IGF-I plasma levels at the time of diagnosis of BC and during follow up.

Results: Sensory neuromuscular examination showed a progressive derangement of EMG suggestive for a neurogenic demage. A reduction of IGF-1 plasma levels was observed from baseline to follow up (P<0.05) where a direct positive correlation with IGF-I plasma levels was also found (P<0.05).

Conclusion: The neurophysiological study confirmed the presence of sensory neuropathy of sural nerve that can be a cause of fatigue in our series of patients; the presence of low plasma levels of IGF-1 at follow up and a direct correlation of these data with EMG was suggestive for a possible direct involvement of somatotrope axis in explaining, in part, the presence of fatigue in breast cancer patients.

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