Systemic Responses Towards Oxy-Inflammation, Hormones, and Mood in Breast Cancer Survivors: Preliminary Evidences from Dragon Boat Endurance Race

Abstract

Background/Objectives: Endurance exercise increases oxygen demand and, when not balanced by antioxidant defenses, consequently, oxidative stress and inflammatory cytokines increase too. In breast cancer survivors (BCS), post-treatment, physical capacity decreases, lowering life quality. Dragon boat (DB) paddling has shown benefits in reducing lymphedema and improving psychological well-being. This study aimed at non-invasively investigating in BCS, by means of saliva and urine samples, the systemic responses to oxy-inflammation, and appetite hormones after a DB endurance race. Methods: 15 BCS and 15 healthy women (5 (CTR) who performed the DB race too) were studied. BCS and CTR were monitored pre- and post-race. Reactive oxygen species (ROS) production, total antioxidant capacity (TAC), lipid peroxidation (8-iso), DNA oxidation (8-OH-dG), nitric oxide metabolites (NOx), inflammation markers (IL-6-10 and TNFα), appetite hormones, electrolytes concentration, psychometric, and physical scales were assessed. Results: At rest, compared to healthy women, BCS showed a significant increase in oxy-inflammation biomarkers. BCS showed a general increase in oxy-inflammation parameters compared to CTR after the DB race. In BCS, there were the following results: ROS: +80%; lipid peroxidation: +103%; DNA oxidation: +44%; interleukins-6: +179%; IL-10: +55%; TNFα: +9%, NOx: +60% increases and unbalanced appetite hormones: leptin (-32%); and ghrelin (+53%). Moreover, the dragon boat offered a holistic approach to recovery, addressing emotional and social needs supporting belonging, love, and esteem needs, reported to be about 56% of the motivations in this activity, while post-race the following increased: a sense of fatigue (+55%); tiredness (48%); a cold sensation (+15%); and +32% pain. Conclusions: This study provided evidence that, in BCS, a DB endurance race produces an important imbalance in the oxy-inflammation state, at the same time being accompanied by a positive impact on subjective mood and general wellness. Future studies should focus on long-term effects.

Keywords: breast cancer; dragon boat; endurance; exercise; hormones; inflammation; mood; oxidative stress; quality of life; women.

Figure 3

Histograms of (A and a) NO metabolites (NOx), (B and b) Nitrite (NO₂), (C and c) creatinine, (D and d) neopterin, and (E and e) uric acid. In capital letters: values of sample concentrations pre- and post-race from the crew components (breast cancer survivors, BCS, and healthy CTR) and at rest for the HFS group. In lower letters: change Δ% estimation of BCS and CTR. Results are expressed as mean ± SD; * q < Q.

Figure 4

Histogram plots (mean ± SD) of (A and a) leptin, (B and b) ghrelin, and (C and c) IGF-1. In capital letters: values of samples concentrations collected pre- and post-race in crew components (breast cancer survivors, BCS, and healthy CTR) and at rest from the HFS group. In lower letters: change Δ% estimation of BCS and CTR. Significantly different results are expressed as mean ± SD; * q < Q.

Figure 1

Sketch of the experimental protocol and map showing the navigation route. Data were collected before departure (Pre-Race), and Post Race “Vogalonga 2023”. Map was obtained by Google, Inst. Geogr. National. Race route Vogalonga 2023: bacino di San Marco, canale delle Navi, canale della Bissa, canale Passaora, canale Crevan, Burano, Mazzorbo, canale S. Giacomo, canale Scomenzera, canale Bisatto, Murano, canale di Tessera, rio di Cannaregio, Canal Grande, Rialto, Punta della Salute.

Figure 2

Histograms of: (A and a) ROS production and (B and b) TAC by saliva; (C and c) 8-iso PGF2α and (D and d) 8-OH-dG by urine; (E and e) IL-6, (F and f) TNF-α, and (G and g) IL-10 by saliva. In capital letters: values of samples concentrations collected pre- and post-race from the crew components (breast cancer survivors (BCS) and healthy participants (CTR)) and at rest from the HFS group. In lower letters: change Δ% estimation of BCS and CTR. Results are expressed as mean ± SD; * q < Q; ** p < 0.01.

Figure 5

(A) VAS scores for general wellness, tiredness, cold, agitation, pain, and fatigue assessed pre-, post-race, and 24 h after the race. Statistically significant difference comparisons are displayed: * p < 0.05; ** p < 0.01 *** p < 0.001. In (B), the chart shows the pain area with respect to the display of part-to-whole relationships. In (C), Maslow’s pyramid is displayed (based on Maslow, 1954, https://www.simplypsychology.org/maslow.html; last access 11 April 2023).

Figure 6

Heatmap of the correlation matrix post-race. Mean of side-by-side replicates. The bar on the right side of the map indicates the color legend (from −1 to 1) of the Spearman correlation coefficients calculated for each couple of variables in the matrix. The Spearman rank correlation test was used. p < 0.05 value was accepted as significant.