Body weight and breast cancer risk before menopause. Women who are overweight or obese before menopause have a 20 to 40 percent lower risk of breast cancer than those who are lean [ 12,54-56 ]. Body weight and breast cancer risk after menopause. Women who are overweight or obese after menopause have a 30 to 60 percent higher breast cancer risk than those who are lean [ 54-56 ]. How can body weight affect breast cancer risk after menopause? Women with higher estrogen levels have an increased risk of breast cancer compared to women with lower estrogen levels [ 18 ]. Learn more about estrogen and breast cancer risk . Weight gain and breast cancer risk. Gaining weight in adulthood appears to increase the risk of breast cancer before and after menopause [ 65-68 ]. The weight a woman gains after menopause also appears to increase their risk of breast cancer [ 65,69 ]. Weight loss and breast cancer risk. Losing weight after menopause may help lower risk of breast cancer [ 65 ]. Weight loss in adulthood and breast cancer risk before menopause is under study [ 71 ]. Body shape and breast cancer risk. Body weight and breast cancer survival.
Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. Weight change during chemotherapy is reported to be associated with a worse prognosis in breast cancer patients, both with weight gain and weight loss. Weight gain in breast cancer patients has been associated with anti-neoplastic chemotherapy in the majority of studies. There is also substantial evidence that weight change during chemotherapy may be associated with a worse prognosis for the cancer patient, both with weight gain [ 12 ] and weight loss [ 13 ]. Only one recent study reported some evidence that women with early breast cancer, who had a weight loss during treatment, were at higher risk of recurrence and death compared to women with no weight variation [ 18 ]. Our study thus investigated the prognostic value (death and recurrence) of weight variation during anthracycline-based chemotherapy treatment of breast cancer in a French population with a long-term follow-up. We also verified the association of weight at breast cancer diagnosis with survival. Among the 709 women treated with chemotherapy treatment for breast cancer, 111 women were included in the analysis. Seventeen percent of the women were diagnosed with stage I breast cancer while 48% had stage II and 35% had stage III respectively. The present study is in agreement with previous studies which have found that overweight at the time of diagnosis increased both breast cancer recurrence and mortality. Demark-Wahnefried W, Winer EP, Rimer BK: Why women gain weight with adjuvant chemotherapy for breast cancer. Rock CL, Demark-Wahnefried W: Nutrition and survival after the diagnosis of breast cancer: a review of the evidence.
Treating and managing these symptoms can help you feel better and allow you to continue with more of your usual activities. These substances can lead to weight loss, muscle loss, and a decrease in appetite. They can also lead to side effects such as nausea, vomiting, and mouth sores, which can affect your ability to eat normally, further contributing to weight and muscle loss. Fatigue is also a factor, since the decreases in exercise and other physical activities that happen when you’re not feeling well can also contribute to muscle loss. How are weight changes and muscle loss treated? These drugs can increase appetite for some people and may help to prevent weight and muscle loss, but they do not build up lost muscle tissue. What can I do to help maintain my weight and build strength? You can also try some upper body exercises while sitting in a chair – moving your arms up and down and front to back can help maintain flexibility. Making a fist and lifting your arms up and down in front of you can increase strength. Note the type of exercises or other physical activities you do and how they affect your mood and energy level. Nutritionists and physical or occupational therapists can advise you on other ways to maintain your weight and build strength as you cope with cancer.
Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer. This may fuel the development of breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk of breast cancer. Symptoms of advanced breast cancer may include: Swelling of the lymph nodes in the armpit (next to the breast with cancer) However, the importance of self-exams for detecting breast cancer is debatable. CT scan to check if the cancer has spread outside the breast. Mammography to screen for breast cancer or help identify the breast lump. Type and stage of the cancer. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). Even with treatment, breast cancer can spread to other parts of the body. Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor. This is surgery to remove the breasts before breast cancer is diagnosed. Cancer of the breast.
The 3-factor profile (weight loss, reduced food intake, and systemic inflammation) identifies patients with both adverse function and prognosis. The purpose of the present study was to evaluate in a homogeneous cohort of patients with cancer the role of weight loss, low food intake, and the presence of systemic inflammation in a multiple-factor profile of cachexia which aimed to reflect patients' adverse function and survival duration. Nutritional and functional characteristics of the patients (n = 170) according to weight loss (≥10%)1. Differences in the patients' nutritional and functional characteristics on the basis of the 3-factor cachexia profile (weight loss, food intake, and inflammatory status) are shown in Table 3 ⇓ . With weight loss ≥ 10%, food intake ≤ 1500 kcal/d, and CRP ≥ 10 mg/L, 22% (37 of 170) of patients met the cachexia profile definition. Nutritional and functional characteristics of the patients (n = 170) according to the multifactor profile of cachexia (weight loss ≥10%, food intake ≤1500 kcal/d, C-reactive protein ≥10 mg/L)1. Differences in the patients' nutritional and functional characteristics on the basis of having met ≥2 of the 3 factors in the 3-factor cachexia profile are shown in Table 4 ⇓ . Nutritional and functional characteristics of the patients (n = 170) according to whether or not they met ≥ 2 of 3 factors of the multifactor profile of cachexia (weight loss ≥10%, food intake ≤1500 kcal/d, C-reactive protein ≥10 mg/L)1. When the individual factors in the 3-factor cachexia profile were included, log CA 19-9, KPS, LBM, health status, food intake, and CRP (but not weight loss) carried prognostic value. When the 3-factor cachexia profile was included in the model for patients with localized disease, log CA 19-9 [hazard ratio (HR): 1.35; P = 0.019] and the profile itself (HR: 4.94; P < 0.001) were prognostic. When the cachexia profile model in which ≥2 of the 3 factors were met was use included, log CA 19-9 (HR: 1.31; P = 0.026) and the profile itself (HR: 2.40; P < 0.001) were prognostic. For patients with metastatic disease, log CA 19-9 (HR: 1.47; P = 0.007) and dyspnea (HR: 1.01; P = 0.025) were prognostic when either the 3-factor cachexia profile or the met ≥2 of 3 factors in the profile were included in the model. In the present study when all 3 factors were used to characterize cachexia, 22% of the population was identified with both objective and subjective loss of functional ability.
Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study. Adult weight change and risk of postmenopausal breast cancer. Body size and breast cancer risk: The multiethnic cohort. Risk factors of breast cancer in elderly women. Adiposity, adult weight change, and postmenopausal breast cancer risk. Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Adult weight change and incidence of premenopausal breast cancer. Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women. A prospective study of body size and breast cancer in black women. Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States). Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis.
More and more we are finding that exercise and a healthy diet improve the outcomes for our patients with breast cancer, and we have seen more data at this meeting. Ligibel, MD: It is interesting that the first study that looked at the relationship between a woman's weight at the time she is diagnosed with breast cancer and risk for recurrence and mortality was published in the 1970s. Since that time, there have been more than 100 similar studies looking at the links between weight at diagnosis or a few months or years before or immediately after diagnosis, and the risk for cancer occurrence and mortality. It showed that the risk for breast cancer mortality in premenopausal women with hormone receptor-positive disease was an absolute 5% higher in obese vs nonobese women. Another analysis  looked at both hormone receptor–negative and hormone receptor–positive groups of women, all showing that being obese at the time of breast cancer diagnosis is linked to a higher risk for cancer-related mortality.  We found the exact same thing: that ideal doses of chemotherapy did not change the relationship between poor outcomes and weight.  In that study we saw poor outcomes in both hormone receptor–positive and hormone receptor–negative women who were obese at the time of diagnosis. Studies have looked at the characteristics of cancer in obese vs nonobese women, and they haven't shown a lot of consistent patterns. It was not a large enough difference to explain the differences in outcomes seen in other studies that looked at clinical characteristics—such as grade and ER status—and didn't see differences between obese and nonobese women. Also, the benefit was seen mostly in the ER-negative patients, and I was perhaps naively expecting that if this was going to have a benefit, it would be in the ER-positive patients. At that point we thought that all of the relationships between weight and physical activity were mediated by estrogen. Since that time there has been an enormous growth in the translational science looking at energy balance, weight, physical activity, and diet and how they affect cancer. Many studies have suggested that having a coach—someone who is able to break the information down and provide motivation—is important. In many of the intervention studies that I have seen, they are 8, 12, or 16 weeks.
Does body weight affect cancer risk? What does the American Cancer Society recommend about body weight? These factors are all related and may all contribute to cancer risk, but body weight seems to have the strongest evidence linking it to cancer. But the links between body weight and cancer are complex and are not yet fully understood. For example, while studies have found that excess weight is linked with an increased risk of breast cancer in women after menopause, it does not seem to increase the risk of breast cancer before menopause. The timing of weight gain might also affect cancer risk. Clearly, more research is needed to better define the links between body weight and cancer. How might body weight affect cancer risk? Excess body weight may affect cancer risk through a number of mechanisms, some of which might be specific to certain cancer types. Does losing weight reduce cancer risk? Research on how losing weight might lower the risk of developing cancer is limited. Still, there’s growing evidence that weight loss might reduce the risk of breast cancer (after menopause), more aggressive forms of prostate cancer, and possibly other cancers, too.
Weight gain can raise your risk for getting high blood pressure , heart disease , and diabetes . Research has also shown that carrying around extra pounds can raise your risk of breast cancer recurring. Weight loss can cause you to lose energy, and poor nutrition can make it harder for you to recover. A diet low in total and saturated fat helps lower your risk of heart disease , and also lowers the risk that your breast cancer will return. Good nutrition can help you with the side effects of chemotherapy , and help fight off infections. Physical activity can often help reduce the side effects of nausea and fatigue . It can also lift your energy levels. Strength training can help rebuild body mass and increase your strength.
Weight Loss After Breast Cancer Diagnosis May Not Improve Prognosis. In Journal of Clinical Oncology, Litton et al 1 and Griggs and Sabel 2 have suggested weight reduction as a potential antitumor intervention in obese women with newly diagnosed breast cancer. A wide variety of studies have documented the more advanced disease at diagnosis, 3 and worse prognosis after diagnosis, 4 – 6 associated with obesity in women with breast cancer. At inception, the developing genetic characteristics of each breast cancer are apparently influenced by the biochemical-hormonal tissue environment of the patient, resulting in different primary tumor genetic characteristics in obese and nonobese women. These include differences in the frequency and concentration of hormone receptor sites, 7 , 8 nuclear grade, 1 and cancer stage, 1 and seem likely to have already influenced primary growth, metastasis, and growth of metastatic tissues before tumor diagnosis. 9 The similar prognosis for obese and nonobese women receiving tamoxifen therapy for relatively less aggressive estrogen receptor–positive, node-negative tumors 10 supports an association between tumor prognosis and the obesity-associated genetic characteristic of primary tumors, rather than between tumor recurrence rates and the altered hormonal levels characteristic of obesity. These differences were independent of patient age, smoking habits, tumor stage, and estrogen receptor status, and seemed explainable only by the presence of more highly malignant tumors among these obese women associated with earlier tumor metastasis, or by the more rapid growth of node metastases before diagnosis. Any study examining the influence of postdiagnosis weight reduction on subsequent tumor prognosis would include the potential handicap of creating undeserved guilt among women with recurrent tumors who had been unsuccessful in their efforts to lose weight. Although the diagnosis of breast cancer may stimulate some women to be more successful in these programs, weight loss may be more difficult for others because of their new diagnosis as well as any new symptoms induced by antitumor therapy. If weight loss is recommended to these women, physicians should be certain that their patients clearly understand the absence of evidence suggesting weight loss as a technique for limiting tumor recurrences, in order to protect against inappropriate self-criticism. Litton J, Gonzales-Angulo A, Warneke C, et al: Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer. Dignam J, Wieand K, Johnson K, et al: Obesity, tamoxifen use, and outcomes in women with estrogen receptor-positive early-stage breast cancer.
Weight loss is common among people with cancer and is often the first noticeable sign of the disease. As many as 40% of people with cancer report unexplained weight loss at the time of diagnosis, and up to 80% of people with advanced cancer experience weight loss and cachexia, or wasting, which is the combination of weight loss and muscle mass loss. Weight loss and muscle wasting also often come with fatigue , weakness, loss of energy, and an inability to perform everyday tasks. Controlling cancer-related weight loss is important for your comfort and well-being. Consider asking your doctor about receiving food through a tube that goes directly to the stomach, which may help people with head and neck or esophageal cancers who are having difficulty chewing or difficulty swallowing . Megestrol acetate (Megace) is a progesterone hormone that can improve appetite, weight gain, and a person's sense of well-being. Steroid medications can increase appetite, improve a person's sense of well-being, and help with nausea, weakness, or pain. Other medications are being studied to help people with cancer improve their appetite and gain weight. Nutrition counseling may help people with cancer get essential nutrients, such as protein, vitamins, and minerals into their diet and maintain a healthy body weight. You can also find a dietitian through the Academy of Nutrition and Dietetics. These details can help you work with your health care team to find the best way to maintain your weight, or gain needed weight, during cancer treatment.
Breast Cancer Diet. In this book he outlines simple and practical food and lifestyle choices that women can implement to lower the risk of being affected by breast cancer . Breast Cancer Diet Basics. Tabor explains the factors that can increase cancer risk and outlines medical research showing that diet and lifestyle can play a major role in prevention of breast cancer. Specific foods and supplements are highlighted that can help fight and prevent breast cancer as well as other diseases. Diet for Breast Cancer Survivors. The Whole-Food Guide for Breast Cancer Survivors presents vital information for creating a personalized plan for breast cancer prevention . Walking is recommended on the breast cancer diet for thirty to forty five minutes a day, six days a week. The Whole-Food Guide for Breast Cancer Survivors: A Nutritional Approach to Preventing Recurrence retails at $18.95. In addition to the lack of specific guidelines the dietary recommendations given for weight loss are not in accordance with the high intakes of fruit and vegetables that have been indicated to be necessary to reduce the risk of breast cancer. The advice given will certainly result in improvements to health and a reduction in the risk of breast cancer for dieters who are currently eating a standard Western diet. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. Breast cancer research and treatment, 134(2), 479-493. Soy food consumption and breast cancer prognosis. Diet quality indices and postmenopausal breast cancer survival.
Breast Cancer Treatment and Weight Changes. Your weight might change when you get treated for breast cancer . What Might Cause Me to Gain Weight? Menopause also causes you to gain more body fat and lose lean muscle. Another reason for weight gain is the use of corticosteroids. They can make you lose muscle mass in your arms and legs, and gain belly fat, too. Women treated with steroids may also put on pounds, but the weight gain is usually seen only after weeks of continuous use. Some research suggests that weight gain is also related to lack of exercise . When you get your cancer treatment , it’s common to feel stress and have some fatigue , nausea , or pain. Weight gain may also be related to intense food cravings . Do Other Breast Cancer Medications Cause Weight Gain? Many women taking tamoxifen have felt the drug was responsible for their weight gain.
PCM in cancer results from multiple factors most often associated with anorexia, cachexia, and the early satiety sensation frequently experienced by individuals with cancer. Anorexia, the loss of appetite or desire to eat, is typically present in 15% to 25% of all cancer patients at diagnosis and may also occur as a side effect of treatments. Cachexia is estimated to be the immediate cause of death in 20% to 40% of cancer patients; it can develop in individuals who appear to be eating adequate calories and protein but have primary cachexia whereby tumor-related factors prevent maintenance of fat and muscle. The etiology of cancer cachexia is not entirely understood. Anorexia, cachexia, and nutrition. American Cancer Society: Nutrition for the Person with Cancer: A Guide for Patients and Families. Vigano A, Watanabe S, Bruera E: Anorexia and cachexia in advanced cancer patients. Shils ME: Nutrition and diet in cancer management. Ottery FD: Cancer cachexia: prevention, early diagnosis, and management. Zeman FJ: Nutrition and cancer. Also known as cachexia, this condition is one of advanced protein-calorie malnutrition and is characterized by involuntary weight loss, muscle wasting, and decreased quality of life.[ 1 , 2 ] Tumor-induced weight loss occurs frequently in patients with solid tumors of the lung, pancreas, and upper gastrointestinal tract and less often in patients with breast cancer or lower gastrointestinal cancer. Although an individual’s nutritional status may be compromised initially by the diagnosis of cancer, thorough nutritional screening procedures and the timely implementation of nutritional therapies may markedly improve the patient’s outcome. Several approaches to the treatment of cancer cachexia have been reported, and a variety of agents have been studied for their effects on appetite and weight. Table 1 lists several medications that have been proposed to treat the symptoms of cancer cachexia.[ 13 ] However, the management of cachexia remains a complex challenge, and integrated multimodal treatment targeting the different factors involved has been proposed.
Breast Cancer Recurrence Risk Goes Up With Weight. Even being moderately overweight is linked to a higher risk of breast cancer recurrence, finds a new study published Monday in the journal Cancer. The increase in hormone and inflammation can cause some breast cancer cases to spread - and even to recur. This study found that despite optimal treatment, including chemotherapy and hormonal therapy, the increased body mass index - which usually corresponds to the body's fat content - significantly increased women's risk of cancer recurrence and death. Additionally, the more obese the patient is, the more likely they are to have breast recurrence and death from this cancer. Clifford Hudis, chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center in New York, is part of a team that has investigated the connection between weight and cancer incidence. In the new study, the type of breast cancer that was increased was hormone receptor-positive, the most common type of breast cancer that accounts for two-thirds of all breast cancer cases in the United States and worldwide. "We absolutely believe that weight loss is critical to prevention of breast cancer, as well as recurrence," said Dr.
From my perspective as a nutrition professional, the best ones are the ones that work for you, and every woman can be different. So you may want to discuss with your doctor if there are other options for medications if you really believe it's the tamoxifen that is the problem. Melinda Irwin I would have a more in-depth talk with your oncologist about this issue and how much it's bothering you. Question from Mel: What about the use of vitamins and supplements in weight loss? I keep hearing that there are good carbs and bad carbs, like on the South Beach diet. Melinda Irwin The other thing to remember is that alcohol has calories and sugar, so if you're trying to lose weight it may be best to have water or a lower calorie beverage. I would suggest that you not just think of body weight as the only measure of your health. If you're in your young 50s and were going through menopause either after or during the tamoxifen and prior to the Actonel, that could have caused some of the weight gain. Irwin, I saw that you've published on the effect of exercise on breast cancer biomarkers and the influence of physical activity on obesity. How much exercise is recommended to influence the effect on biomarkers, and what does that mean? Question from Juicyfruit: Could you talk about the recommendation I've read that suggests eating lots of different colors of fruits and veggies? If you have been exercising prior to treatment, maintain that program as best as you can to avoid any potential weight gain and to maintain your lean body mass, which may decrease as a result of therapy.
Results: Weight change after 12 months of intervention was as follows (mean ± SD): 0.85 ± 6.0 kg in the control group, −2.6 ± 5.9 kg in the Weight Watchers group, −8.0 ± 5.5 kg in the individualized group, and −9.4 ± 8.6 kg in the comprehensive group that used both individualized counseling and Weight Watchers. Weight loss relative to control was statistically significant in the comprehensive group 3, 6, and 12 months after randomization, whereas weight loss in the individualized group was significant only at 12 months. Weight loss of 10% or more of initial body weight was observed in 6 of 10 women in the comprehensive group at 12 months. Discussion: These data indicate that the most weight loss was achieved when the counseling approach combined both Weight Watchers and individualized contacts. The aim of this study was to develop and test individualized methods for effective weight loss in obese breast cancer survivors. Weight loss was most rapid in the comprehensive arm, with mean weight losses of 7.4, 9.3, and 9.4 kg at 3, 6, and 12 months, respectively ( Figure 1 ). Weight loss for the two arms that required Weight Watchers attendance (WW and Comprehensive). The respective mean attendance for women in the comprehensive arm were 93%, 79%, and 52%. Attendance at WW from 6 to 12 months was still associated significantly with incremental weight loss during that time period, and the only women who lost more weight from 6 to 12 months were those in the comprehensive arm who also attended 47% or more of the weekly WW meetings ( Figure 2 ). The association of weight loss and average group attendance from 0 to 12 months was significant (r = 0.775, p = 0.014), with subjects attending 9% to 92% of the monthly groups during that time. The mean numbers of telephone contacts with participants in the individualized arm was 10 in the first 3 months, 6 in the next 3 months, and 10 in the last 6 months of intervention. In the control arm, mean reported energy intakes were 2246, 1691, 1918, and 2120 kcals at baseline and 3, 6, and 12 months, respectively, but the reported decrease in energy intake at 3 months was not evident in terms of weight loss. Despite this, those two women exhibited weight losses of 5.8% and 8.9% of baseline weight at 12 months, which was not widely disparate from the mean weight loss of 9.2% in that arm. The WW program alone can result in significant weight loss, and 4.8 kg was achieved in one study that used WW only for 6 months ( 41 ).
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Breast cancer most commonly develops in cells from the lining of milk ducts and the lobules that supply the ducts with milk. Outcomes for breast cancer vary depending on the cancer type, extent of disease , and person's age.  Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases. The primary risk factors for breast cancer are female sex and older age. A number of dietary factors have been linked to the risk for breast cancer.  In those with zero, one or two affected relatives, the risk of breast cancer before the age of 80 is 7.8%, 13.3%, and 21.1% with a subsequent mortality from the disease of 2.3%, 4.2%, and 7.6% respectively.  In those with a first degree relative with the disease the risk of breast cancer between the age of 40 and 50 is double that of the general population. The best known of these, the BRCA mutations , confer a lifetime risk of breast cancer of between 60 and 85 percent and a lifetime risk of ovarian cancer of between 15 and 40 percent. The management of breast cancer depends on various factors, including the stage of the cancer and the age of the patient. Conventionally radiotherapy is given after the operation for breast cancer. Worldwide, breast cancer is the most common invasive cancer in women. Breast cancer staging systems were developed in the 1920s and 1930s. The emphasis on breast cancer screening may be harming women by subjecting them to unnecessary radiation, biopsies, and surgery.
The most common symptom of breast cancer is the feeling the presence of a lump or an area of thickened tissue over the breast. Breast cancer still remains one of the most commonly diagnosed cancer among women and kills thousands worldwide each year. Lump within the breast. This may be a lump that is fixed to the skin above it or the chest wall and structures underlying it. Thickened tissue over the skin of the breast. Formation of dimples over the skin of the breast especially when arms are raised or moved. The dimples give the breast a pitted appearance and the skin change is called Peau d’orange or orange peel appearance. Change in the shape and appearance of one or both nipples. Pain in either of the breast or armpits not related to periods. This leads to swelling of the arm(s) next to the affected breast.
Breast cancer patients who gain weight after diagnosis have worse prognosis. Many women experience weight gain during chemotherapy and endocrine treatment for breast cancer. The evidence suggests that women should monitor their weight and avoid weight gain after a diagnosis of breast cancer. Weight gain is common during breast cancer treatment. Nevertheless, for most women, the weight gain after breast cancer is modest - one study estimated that a weight gain of more than 22 lbs takes place in fewer than 10% of breast cancer survivors. One study reported that younger women and women who were underweight or normal weight at the time of cancer diagnosis were the most likely to gain weight and to experience increases in percent body fat. A large minority of women, including some whose weight was stable during treatment, also experience progressive weight gain in the years after treatment. However, note that one 2012 study reported that weight loss during anthracycline chemotherapy was associated with poorer survival in women with early-stage breast cancer than stable weight. Study that examined weight gain among women aged 40 to 54 who received chemotherapy reported that women of normal weight gained an average of 4.3 pounds during the first year. Greater weight gain was found among women who had lower body mass index ( BMI ) at diagnosis, had more advanced disease stage, were younger, were premenopausal, or who had been treated with chemotherapy or radiation treatment during the first six months after cancer diagnosis. Weight gain after developing breast cancer worsens prognosis. Study reported that women with ER+ disease who had a pre- to post-diagnosis weight gain (measured at approximately the two-year mark) of at least 10% were more likely to experience late recurrence (more than five years after diagnosis) of breast cancer. Study investigated the effects of weight gain on survival among 1,436 women diagnosed with breast cancer during 1996 or 1997. A study that included 5,204 Nurses' Health Study participants who were diagnosed with breast cancer between 1976 and 2000 reported that among never-smoking women, those whose BMI increased by more than 2.0 kg/m(2) (median gain, 17.0 lbs) had 1.64 times the risk of breast cancer-specific death as women who maintained their weight during a median follow-up period of nine years.
Weight loss is a common complication of cancer and cancer treatments that can result in a poor prognosis for patients. While not all cancer patients will develop anorexia and subsequent weight loss, anorexia and weight loss are very common. Anorexia may result from the cancer, chemotherapy, radiation or a variety of other causes, including physical and psychological causes. These changes can lead to anorexia and weight loss. Why is it important to manage anorexia and weight loss? Not only can anorexia interfere with treatment, it can cause concern for both you and your family. How can anorexia and weight loss be managed? The best way to manage anorexia and weight loss is to prevent them from occurring in the first place. Some approaches that may help prevent anorexia and weight loss may include: Both chemotherapy and radiation therapy cause nausea and vomiting, which can lead to anorexia and weight loss. In 139 patients with anorexia and weight loss, Marinol® significantly increased appetite after 4 weeks. Several studies have established that Megace® causes appetite stimulation and weight gain in cancer patients with anorexia. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.
In Journal of Clinical Oncology, Litton et al 1 and Griggs and Sabel 2 have suggested weight reduction as a potential antitumor intervention in obese women with newly diagnosed breast cancer. A wide variety of studies have documented the more advanced disease at diagnosis, 3 and worse prognosis after diagnosis, 4 – 6 associated with obesity in women with breast cancer. At inception, the developing genetic characteristics of each breast cancer are apparently influenced by the biochemical-hormonal tissue environment of the patient, resulting in different primary tumor genetic characteristics in obese and nonobese women. These include differences in the frequency and concentration of hormone receptor sites, 7 , 8 nuclear grade, 1 and cancer stage, 1 and seem likely to have already influenced primary growth, metastasis, and growth of metastatic tissues before tumor diagnosis. These differences were independent of patient age, smoking habits, tumor stage, and estrogen receptor status, and seemed explainable only by the presence of more highly malignant tumors among these obese women associated with earlier tumor metastasis, or by the more rapid growth of node metastases before diagnosis. Any study examining the influence of postdiagnosis weight reduction on subsequent tumor prognosis would include the potential handicap of creating undeserved guilt among women with recurrent tumors who had been unsuccessful in their efforts to lose weight. Although the diagnosis of breast cancer may stimulate some women to be more successful in these programs, weight loss may be more difficult for others because of their new diagnosis as well as any new symptoms induced by antitumor therapy.
The prognostic effect of weight loss prior to chemotherapy was analyzed using data from 3,047 patients enrolled in 12 chemotherapy protocols of the Eastern Cooperative Oncology Group. Median survival was significantly shorter in nine protocols for the patients with weight loss compared to the patients with no weight loss. Within performance status categories, weight loss was associated with decreased median survival. These observations emphasize the prognostic effect of weight loss, especially in patients with a favorable performance status or a limited anatomic involvement with tumor.
Although people more commonly lose weight during cancer treatment, some people gain weight. However, significant weight gain may affect a person's health and ability to undergo treatment. Weight gain is an especially important health issue for women with breast cancer because more than half experience weight gain during treatment. Reports have shown that weight gain during treatment is linked to a poorer prognosis, which is the chance of recovery. The following cancer treatments may lead to weight gain: Some chemotherapy causes the body to hold on to excess fluid in cells and tissues, which is called edema . It may also cause menopause in some women, which decreases their metabolism, increasing the likelihood of weight gain. Steroids may also cause the loss of both weight and muscle mass, which is called wasting. Hormonal therapy for the treatment of breast, uterine, prostate, and testicular cancers involves medications that decrease the amount of estrogen or progesterone in women and testosterone in men. They can help find out the possible cause of the weight gain and the best way to manage it. Consider the following ways to address weight gain through diet and physical activity:
A positive association between obesity and the risk of incident postmenopausal breast cancer has been consistently observed in epidemiologic studies. In this article, the authors review the evidence linking obesity with breast cancer risk and outcomes and provide an overview of lifestyle intervention studies in patients with breast cancer. The review that follows provides an overview of the evidence relating obesity with breast cancer by subtype, including the associations of obesity with cancer incidence, recurrence, and survival. Multiple studies of postmenopausal women have shown strong associations between obesity and the risk of ER+/PR+ breast cancer but not other breast cancer subtypes. 15 A meta-analysis found an overall relative risk (RR) of 1.20 (95% CI: 1.11–1.30) for the association of diabetes and breast cancer. Metformin may reduce the risk of breast cancer and its recurrence through several mechanisms. Meta-analyses have shown that metformin use in patients with diabetes is associated with reduced risk of postmenopausal breast cancer OR = 0.82; 95% CI: 0.71–0.97), 19 and reduced breast cancer mortality (summary relative risk = 0.63; 95% CI: 0.40–0.99). Until recently, there were relatively few studies evaluating the efficacy and potential benefits of weight loss interventions in patients with breast cancer. However, as the evidence linking obesity to breast cancer recurrence and mortality has grown, along with the proportion of U. Obesity is associated with the risk of incident breast cancer in postmenopausal but not menstruating women and with risk of cancer recurrence and mortality in patients with early-stage breast cancer, regardless of menopausal status.
Weight change during chemotherapy is reported to be associated with a worse prognosis in breast cancer patients, both with weight gain and weight loss. Weight gain in breast cancer patients has been associated with anti-neoplastic chemotherapy in the majority of studies. There is also substantial evidence that weight change during chemotherapy may be associated with a worse prognosis for the cancer patient, both with weight gain [ 12 ] and weight loss [ 13 ]. The findings reported by the few studies which have explored the prognostic value of weight gain after a diagnosis of breast cancer are mixed: four studies reported that weight gain was associated with a decreased overall survival and increased recurrence risk [ 8 , 14 - 16 ] whereas five others failed to report such associations [ 10 , 9 , 17 ]. Only one recent study reported some evidence that women with early breast cancer, who had a weight loss during treatment, were at higher risk of recurrence and death compared to women with no weight variation [ 18 ]. Our study thus investigated the prognostic value (death and recurrence) of weight variation during anthracycline-based chemotherapy treatment of breast cancer in a French population with a long-term follow-up. We also verified the association of weight at breast cancer diagnosis with survival. Among the 709 women treated with chemotherapy treatment for breast cancer, 111 women were included in the analysis. Seventeen percent of the women were diagnosed with stage I breast cancer while 48% had stage II and 35% had stage III respectively. The present study is in agreement with previous studies which have found that overweight at the time of diagnosis increased both breast cancer recurrence and mortality. Only one recent study reported some evidence that women with early stage breast cancer treated with chemotherapy and/or radiation and tamoxifen who had large weight loss (> 10%) were at higher risk of recurrence and death compared to women with no weight variation. Literature on the prognostic value of weight variation reported some evidence that women who had gained or lost weight have a higher risk of recurrence and death compared to women with no weight variation.
Cancer Cachexia: Mechanisms and Clinical Implications. The prevalence of cachexia is thought to be up to 80% of upper gastrointestinal cancer patients and 60% of lung cancer patients at the time of diagnosis [ 9 ]. A classic study by De Wys and colleagues underscores the impact and outcome of weight loss in cancer patients [ 2 ]. Baracos, “Understanding and managing cancer cachexia,” Journal of the American College of Surgeons, vol. López-Soriano, “Cancer cachexia: the molecular mechanisms,” International Journal of Biochemistry and Cell Biology, vol. Ross et al., “Acute-phase protein response and survival duration of patients with pancreatic cancer,” Cancer, vol. Carter, “Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer,” Annals of Surgery, vol. Mc Ardle, “Prognostic factors in advanced gastrointestinal cancer patients with weight loss,” Nutrition and Cancer, vol. Mc Millan, “An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer,” Proceedings of the Nutrition Society, vol. Milroy, “A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer,” Lung Cancer, vol. Wigmore et al., “The influence of systemic inflammation, dietary intake and stage of disease on rate of weight loss in patients with gastro-oesophageal cancer,” British Journal of Cancer, vol. Wigmore, “Systemic inflammation, cachexia and prognosis in patients with cancer,” Current Opinion in Clinical Nutrition and Metabolic Care, vol. Glimelius, “The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy,” Anticancer Research, vol. Fearon, “Effect of oral Eicosapentaenoic acid on weight loss in patients with pancreatic cancer,” Nutrition and Cancer, vol. -adrenoceptor activity and resting energy metabolism in weight losing cancer patients,” European Journal of Cancer, vol.
Background: To examine the effects of prediagnostic obesity and weight gain throughout the life course on survival after a breast cancer diagnosis, we conducted a follow-up study among a population-based sample of women diagnosed with first, primary invasive, and in situ breast cancer between 1996 and 1997 (n = 1,508). Women diagnosed with postmenopausal breast cancer who gained more than 12.7 kg after age of 50 years up to the year before diagnosis had a 2- to 3-fold increased risk of death due to all-causes (HR, 2.69; 95% CI, 1.63-4.43) and breast cancer (HR, 2.95; 95% CI, 1.36-6.43). We investigated the effects of prediagnostic adult weight and weight change on mortality among women with breast cancer who participated in the population-based Long Island Breast Cancer Study Project (LIBCSP). Because there were very few cases considered to be underweight (BMI 12.7 kg after the age of 50 years had an increased risk of breast cancer death (HR, 2.95; 95% CI, 1.36-6.43) after adjustment for age at diagnosis, history of hypertension, and weight at age 50 years. However, there was an observed increased risk of overall and breast cancer death among postmenopausal women when comparing weight gain > 5 kg between the ages of 40 and 50 years to those who did not gain weight (overall death HR, 2.69; 95% CI, 1.25-5.79; breast cancer death HR, 2.73; 95% CI, 0.89-8.43). In this population-based study of 1,508 with incident breast cancer with a median of 5.84 years of follow-up, we found that BMI at diagnosis and adult weight gain before diagnosis were associated with increased breast cancer–specific and overall mortality among both women who were premenopausal and postmenopausal at the time of diagnosis. Among women with a postmenopausal breast cancer diagnosis, we also found that high levels of weight gain during the perimenopausal and postmenopausal years were strongly associated with decreased survival after a breast cancer diagnosis. We found that a high BMI and body weight at the time of diagnosis was associated with over a 2-fold increase in mortality among women who were premenopausal at the time of breast cancer diagnosis. Our results are similar to those found in two previous studies that have observed a stronger association between mortality and obesity among women who were premenopausal at the time of their breast cancer diagnosis than those who were postmenopausal ( 8 , 25 ). Our results for prediagnostic weight and weight gain over the adult life course are compatible to another study that also investigated adult weight gain on breast cancer survival. The 2-fold increase in the HR for breast cancer mortality among postmenopausal women seen in our analysis for weight gain in the years leading up to menopause, from age 40 to 50 years, is consistent with this hypothesis.
Unexplained weight loss can be a symptom of many conditions - cancer included. Weight Loss and Cancer. Unintentional weight loss can be a symptom of cancer , though vague and non-specific. When To See Your Doctor About Weight Loss. Generally, you should see your doctor if you have lost 5 percent of your body weight within six months or less and have done so without modifying your diet or exercising. Your doctor may ask you several questions to help identify why you are losing weight. Your doctor will want to know the basics like when you first started to lose weight and how much you have lost. Remember, Weight Loss Doesn't Mean You Have Cancer. You may also get a better understanding of what your symptoms, like weight loss , may mean by using the About.com Symptom Checker , an interactive health education tool.
Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer. About 20 - 30% of women with breast cancer have a family history of the disease. This can fuel the development of breast cancer. Breast implants, using antiperspirants, and wearing underwire bras do not raise the risk of breast cancer. Symptoms of advanced breast cancer may include: Swelling of in the armpit (next to the breast with cancer) Mammography to screen for breast cancer or help identify the breast lump. Type and stage of the cancer. It may be used for women with HER 2-positive breast cancer. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). Even with treatment, though, breast cancer can spread to other parts of the body. Tamoxifen is approved for breast cancer prevention in women aged 35 and older who are at high risk. This is surgery to remove the breasts before breast cancer is ever diagnosed. Women with a strong family history of breast cancer. This may reduce, but does not eliminate the risk of breast cancer.
The Obesity and Breast Cancer Connection: Advancing the Agenda. Given that many women gain weight after breast cancer diagnosis, there are relatively few data from observational studies describing the relationship between weight loss after diagnosis and disease outcomes. There are also no studies examining the impact of purposeful weight loss on breast cancer prognosis. The Women's Interventional Nutrition Study (WINS) randomized 2400 women to a low-fat dietary intervention or a usual-care control group. Patients assigned to the intervention group experienced a 6-lb weight loss and a 24% reduction in breast cancer recurrence vs control participants. Further work is needed to test the impact of weight loss on the risk of recurrence in women with early breast cancer. Observational Studies of Physical Activity and Prognosis in Early Breast Cancer. Observational Studies of Exercise and Breast Cancer Outcomes. This finding adds to the growing evidence that obesity and related factors could affect breast cancer prognosis ( Table 2 ). Weight Loss Intervention Studies in Breast Cancer Populations. Evidence Linking Obesity and Breast Cancer Prognosis. Despite the large number of observational studies demonstrating an association between increased weight at diagnosis and poor prognosis in patients with early breast cancer, there is no direct evidence that weight loss decreases risk of breast cancer recurrence. In addition to the many small studies such as those described above demonstrating that weight-loss interventions are feasible in breast cancer populations, one study has demonstrated sustained weight loss in a larger group of survivors.
While it's more common for people to gain weight during and after treatment, some people lose weight. Managing weight changes. Managing weight gain. Visit the Breastcancer.org Eating to Lose Weight After Treatment pages in the Nutrition section for more tips. Managing weight loss. Visit the Breastcancer.org Eating to Maintain or Gain Weight After Treatment pages in the Nutrition section for more tips.
Obesity and breast cancer are both on the rise worldwide. Excess body weight, poor diet and physical inactivity have been associated with an increased risk of breast cancer in postmenopausal women. The relationship between obesity and breast cancer, however, is complex and not fully understood. What do we know about the relationship between excess body fat and breast cancer? Excess body fat may increase the risk of developing postmenopausal breast cancer through factors that include: In contrast to postmenopausal breast cancer, the relationship between excess body fat and premenopausal breast cancer is less certain. Understanding Breast Cancer Risk Factors. Some women can have multiple breast cancer risk factors and never develop the disease, while others may have no risk factors and develop the disease. Still, it’s important to be aware of your breast cancer risk factors and be able to distinguish between the ones you can change, and the ones you cannot change. Talk to your healthcare provider about your family history of breast cancer and ways to lower your risk.
Findings from a long-term analysis of the Women’s Intervention Nutrition Study (WINS) show that the deaths of women with hormone receptor–negative breast cancers were reduced by up to 54% when they followed a program to reduce their dietary fat intake, which could provide benefit for patients with triple-negative breast cancer. These findings suggest that patients with triple-negative breast cancer, who have an especially poor prognosis, could “substantially increase their chances of survival,” through a lifestyle intervention targeting fat intake associated with weight loss, said Rowan Chlebowski, MD, Ph D, who announced the results at a press conference December 12 at the 2014 San Antonio Breast Cancer Symposium. Women were randomized 60:40 within 6 months of diagnosis to either the dietary intervention arm (n = 975) or the control group (n = 1462). Patients in the intervention group were supported for a median of 5 years. Relapse-free survival was the study’s primary endpoint, and Chlebowski noted that relapse events were 24% lower in the intervention group compared with controls (9.8% vs 12.4%, respectively).1. There were 250 deaths in the control group compared with 133 among those who received the intervention. Chlebowski explained that although the death rate was lower in the intervention group (13.6%) compared with controls (17%), the finding was not statistically significant (HR = .94). For HR-positive patients, there was also no statistically significant effect from the intervention [HR = 1.01]. For the 362 women on the study whose cancers were both ER- and PR-negative, the improved median survival was even more significant in the intervention arm versus controls (14.0 vs 11.7 years, respectively). Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study (WINS). Final survival analysis from the randomized Women’s Intervention Nutrition Study (WINS) evaluating dietary intervention as adjuvant breast cancer therapy.
Breast cancer is the second most lethal cancer in women. The 5-year survival rate for women diagnosed with cancer is 80%. Whether the tumor is hormone receptor-positive or -negative. The good news is that women are living longer with breast cancer. If the cancer is ductal carcinoma in situ (DCIS) or has not spread to the lymph nodes (node negative), the 5-year survival rates with treatment are up to 98%. Breast cancer cells may contain receptors, or binding sites, for the hormones estrogen and progesterone. In addition, women with hormone receptor-positive cancer have more treatment options. Tumor markers relevant for breast cancer prognosis include: The American Cancer Society recommends that all women newly diagnosed with breast cancer get a biopsy test for a growth-promoting protein called HER 2/neu. The HER 2 marker is present in about 20% of cases of invasive breast cancer. In 2008, the FDA approved a new genetic test (Spot-Light) that can help determine which patients with HER 2-positive breast cancer may be good candidates for trastuzumab treatment. The higher the MI, the more aggressive the cancer.