Research News

Endometrial cancer survivors who are more obese have an overall lower quality of life, including poorer sleep and higher levels of depression, according to a new study in the journal Supportive Care in Cancer. The study—led by Jay Alberts, PhD, Lerner Research Institute Department of Biomedical Engineering, and funded by the National Institutes of Health—was a collaboration between Cleveland Clinic and Case Western Reserve University (CWRU). Nora Nock, PhD, Department of Population and Quantitative Health Sciences, CWRU, was first author on the study.

Researchers studied 100 obese Stage I endometrial cancer survivors enrolled in a weight loss program to assess their sleep, level of depression and quality of life. All three components were measured using various scales (Sleep Quality Index, Beck Depression Inventory, and the Functional Assessment of Cancer Therapy-General, with separate criteria to gauge endometrial cancer and fatigue).

The researchers found that nearly three-quarters (72.3%) of obese Stage I endometrial cancer survivors suffered from poor sleep; the higher the level of obesity, the worse the sleep quality, including more frequent sleep disturbances and more daytime dysfunction. The majority (70%) slept less than seven hours a night. These women also had lower quality of life and well-being scores on the different scales.

Uterine cancer cases (the vast majority of which are endometrial cancer) and mortality rates have been rising in the United States in recent years. At the same time, obesity rates, especially so-called “morbid” obesity (Class III), have gone up, particularly among women. Women who are obese have up to a 4.5-times greater risk of developing endometrial cancer than non-obese women. In addition, people who are obese (especially morbidly obese) have a higher prevalence of sleep disorders and depression.

The leading cause of death in women who have endometrial cancer is cardiovascular disease; the risk of death from cardiovascular disease is 50% higher in endometrial cancer patients. Cancer survivors also frequently suffer from sleep disorders, which can have a negative effect on quality of life. In this study, endometrial cancer survivors with “morbid” obesity had much worse sleep quality and depression, poorer physical and emotional well-being, and worse endometrial cancer symptom scores.

“These results demonstrate that we need to do more to combat obesity toward a goal of better sleep and quality of life in patients who have endometrial cancer,” says Dr. Alberts. “With the rise of endometrial cancer cases in the United States, caregivers should strive to recognize when these patients have poor sleep quality and intervene on their behalf.”