Monday, December 10, 2007

Weight Gain after Breast Cancer Reduces Survival Odds

This recent research presentation showed that each 11# gained after a breast cancer diagnosis increased the odds of dying from that diagnosis by 14%. (click on the title of this posting for the news release highlighting this information)

Interestingly, increased risk of death from breast cancer being associated with subsequent weight gained after the diagnosis is not brand new information. This report is just the most recent and the largest study to date to compile data showing that weight gain after a breast cancer diagnosis reduces the odds for long term survival from the disease.

When I spoke at the 2007 American Society of Breast Surgeons annual meeting earlier this year, I presented data from smaller studies already published in the oncology literature that showed increased death from breast cancer associated with weight gained after a breast cancer diagnosis.

My take home messages:

(1) Act on this information right now, no matter if your diagnosis was yesterday or 10 years ago. Don't wait for even more research to "put the nail in the coffin" (sorry to be so blunt). Take advantage of the "teachable moment" that often accompanies a cancer diagnosis.

(2) Don't wait until your breast cancer therapy is completed to actively seek out and engage in making lifestyle changes to minimize the weight gain that is commonly reported with this disease. Weight is harder to get off than keep off.

(3) Don't wait for your doctor(s) to refer you (let alone urge you) to seek the expertise of a Registered Dietitian (RD) to develop an individualized nutritional assessment and plan to guide you in appropriate changes to reduce this risk. (Some will, but don't wait for them to bring it up.)

(4) Don't wait for your cancer center to offer a lifestyle program focusing on diet, nutrition, weight management, exercise, and stress reduction that is integrated as a component of true comprehensive cancer care. (Some do already and some are developing such programs, but don't wait for your center to catch up.)

(5) Don't wait for your medical insurance company to pay for the professional expertise of an RD for cancer recovery or aspects of a more comprehensive recovery program. Be sure to inquire to see what they will pay for and explain the urgency and importance of your request, but don't wait until the Titanic (i.e., the medical insurance industry) gets turned around before you get started with an active plan for lifestyle change to optimize the odds for your full cancer recovery.

Yes, this means that you will need to take an active role to seek out the expertise you will need to get started on these lifestyle and life-saving changes. Make these changes new habits! I call this "Active Hope".

Yes, it means that you may likely need to pay out of pocket for some of these professional services. However, seek out local resources that are starting to provide the lifeboats that cancer survivors need (information and support) to get started. One example is the recent combined efforts of The Wellness Community and The Lance Armstrong Foundation where nutrition and exercise classes specifically for cancer survivors will be offered without charge at YMCA's in 10 cities during 2008 (more info can be found at http://www.thewellnesscommunity.org/education/live_well/index.php)

For those of you reading this who may have already gained weight after your diagnosis, please do not despair or be paralyzed into inaction. A few small studies have shown reduced recurrence rates for breast cancer survivors with weight loss. More research is underway, but please don't wait for that to be finished before taking responsibility for working in partnership with your oncology team in order to fully optimize your odds for cancer recovery. In addition, weight loss will also reduce your risk for (or even improve!) hypertension, diabetes, cardiovascular disease, and osteoarthritis for starters, helping you to live a long and healthy life filled with all the meaningful activities that bring your spirit both joy and happiness. :-)

I hope you get started today!

In the spirit of "Active Hope",

Diana Dyer, MS, RD

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