Risk of Second Cancer Goes Up as Weight Increases
For Women First Diagnosed With Breast Cancer, Risk of Second Cancer Goes Up as Weight Increases
April 13, 2021
If a woman has been diagnosed with breast cancer, her risk of being diagnosed with a second primary cancer increases as her weight increases. Read more...
Comments
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"You might want to talk to your doctor or a registered dietitian about developing a healthy eating plan designed specifically for you and your needs."
THIS should be part of every cancer patient's treatment plan. And not just talking ONCE with an RD, but having a program of follow-up care.
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Another body shaming study from the breast cancer industry. I wonder who funded the study?
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I've had three of the cancers listed, plus a bonus unrelated one. Oh, and I have a mystery lump on my neck that's in a watch and wait phase. I have varied between overweight and lower-range obese for years. I want to know why the hell I'm the one paying for being fat. I joke about being a shit magnet, but underneath I'm torn between why-me rage and bewilderment.
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I carry around about thirty-five extra pounds. They are the same pounds that have clung to my body since adolescence. They're happy there and refuse to be permanently evicted. So once and for all, for every healthcare provider who feels obligated to follow the script and suggest I lose weight, here is my manifesto.
I have lost, and gained back, literally hundreds of pounds in my lifetime. Factoring in my age, genetics, and medical history, for me to lose weight, I must endure constant hunger, constant feelings of deprivation, constant self-denial. It's unsustainable. I will gain it all back and them some, along with large helpings of guilt, self-loathing, and hopelessness. I'm simply not going to do it again, ever. I eat a reasonably balanced, healthy diet. I exercise at least an hour every day. And I'm going to live my life. Now leave me alone.
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yup and the hormone therapy they give you for your first cancer promotes weight gain and makes you have bone muscle and joint pain so you’re less likely to want to work out.
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the lead author of this paper has spent decades of her research time on breast cancer epidemiology. Her job is to identify risk factors. I appreciate her work. It would be negligent of cancer epidemiologists to identify a risk factor and not tell us about it.
http://kpco-ihr.org/bio-feigelson.html
It's important to remind ourselves these large epi studies apply to populations, not individuals.
This tells us there is a population wide, potentially modifiable risk factor which public health and oncologists should discuss with their pts. Ultimately it's the pt's choice what to so with that info.
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Obesity kills.
Mountain Mia, I like your idea. A nutrition and exercise plan with gentle support from our providers would be great.
Moth, right on.
I’d also like to see more research into helping peri menopausal and post menopausal women stay healthy and deal with hormonal and metabolic issues. I believe that much of what I went through as I entered menopause is directly linked to the development of the breast cancer I wound up with. I notice post-menopausal breast cancer is what’s on the list in this article. Right in line with my intuition.
Menopause is the least researched and least understood and supported phase of our reproductive lives
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I don't know. The problem with studies like this is that they don't show that losing weight actually helps prevent recurrence. Because they are comparing heavier women to lighter women, not heavier women to women who used to be heavier and lost weight.
It seems to me it isn't accounting for the impact of *weight loss* at all. For all we know, overweight women are more likely to use unhealthy crash diets that may increase risks. Or the same factors that lead to women being more likely to be heavier may also lead to them being more likely to get breast cancer, and losing weight might not change that.
And according to this study, failure to lose weight may be factor (and I say may because it didn't actually study the impact of weight loss) in 7% of cases. That's really not very high. And especially if a woman's ethnicity isn't white, I'm not sure how seriously she should take this study at all.
There is actually research coming out now that indicates that the heavier a woman is, the worse quality of healthcare she is likely to receive due to implicit (and explicit) bias on the part of the medical system and medical providers. That will not shock anyone who has sought healthcare as a non-thin woman, but it's nice to have the data. But given that, who knows how much of the worse health outcomes are actually due to... worse healthcare.
Basically I am very skeptical of a lot of the coverage around weight and weight loss. And I say this as someone who has been recently successfully losing weight and very happy about it - it's a blast to fit into clothes that I didn't used to fit, but the only thing I can say for sure that is benefiting is my vanity.
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@edj3. Sorry if I offended you however I am entitled to my opinion. My thoughts are similar to @sbelizabeth and salamandra above.
I’m very tired of rude, unprofessional, disrespectful comments coupled with a lack of communication from the healthcare providers. I have little patience for doctors that do not want to explain the rationale for treatment recommendations but expect me to follow their directions without explantation. Is my weight the cause of my BC? I also have a genetic mutation that increases risk for BC and Ovarian cancer Bottom line is we don’t know what caused my BC or my mom’s BC or my maternal aunt and great aunts BC
I also believe that breast cancer is big business and in many (but not all) cases of early stage BC, generating revenue is a driving factor in treatment recommendations
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I have seen studies that show that even if a person loses weight, they still have a higher number of fat cells compared to a person of the same weight who hadn't been heavy, and it's one reason why it's harder to maintain the weight loss. I wonder if that's been taken into account in these cancer comparison studies? And, only somewhat facetiously, for the thin people who still get the same cancers, does it mean there's a fat person inside them trying to express themself?
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I wasn't offended in the least, I was trying to understand your point of view. Thanks for clarifying
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I want to bang my head against a wall every time I’m referred to an RD! I have several cormorbidities and every RD I’ve spoken with (there have been a few) only focuses on one thing. I am more than a condition, or several conditions.
I don’t need one more person passing generic advice like “eat enough lean protein” without talking with me about what I am eating or what my restrictions are.That said, I’ve lost 50 pounds since last June and am working my butt off to lose more. I need a personal trainer who has a sense of humor and some nutrition info, but Covid has shut down all the free cancer fitness programs here
or a personal chef
oh, and I need more time in the day to exercise, cook healthy, work, sleep, do PT exercises, etc.0 -
Salamandra has a good point about studies including women who lost weight vs women who've always been a normal weight. I'm pretty sure I got an email from Army of Women about a study like that. I do hope they're trying to get that data.
Personally I like to know what I might be doing that contributes to my risk. This is no different (even though this particular study doesn't apply to me as I had premenopausal breast cancer), and I don't think the researchers have bad intentions. They're just trying to find things that increase risk. They're not saying that overweight women caused their cancer, they're just saying that if you want to do everything possible to prevent recurrence and you're overweight it might be a good idea to lose weight. If I were going to do everything I could to prevent recurrence I would completely abstain from alcohol, but I don't. The small increased risk doesn't bother me, and I don't feel like I caused my BC because I didn't abstain before my diagnosis.
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So many "studies" to prove what's good or bad:
Coffee is bad for you - oh, wait, coffee is good for you.
Meat is bad for you - oh, wait, meat is good for you.
Dairy, alcohol, chocolate... the list goes on and on.I probably got cancer because I ate/drank _____________.
I truly think that stress causes us more harm than what we eat, drink or weigh. I do try to be mindful of what I eat and drink, and I watch my weight, but to be critical of another's habits or weight just feels wrong. And stressing about it doesn't change or help.
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I agree with Moth. If there is something that we can do to help decrease our chance of recurrence that is within our control, it’s definitely a good thing!
My problem with these “studies” is that patients with Stage 1 breast cancer versus Stage 3 breast cancer are in completely different categories when it comes to chances of recurrence. Add to that, it depends on what type of breast cancer you had and whether or not you had chemotherapy and invasive versus non invasive radiation, as well as oncotype; to give more accurate data of recurrence. I wish that studies would differentiate and not lump every breast cancer patient into the same pot and do more individualized, specific studies.
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"If there is something that we can do to help decrease our chance of recurrence that is within our control, it's definitely a good thing!"
Yes. But if someone hasn't ever had to try to lose a significant amount of weight, they should perhaps not comment on this topic. It's inconsiderate and a bit smug.
(Not aimed at you, Kikki, I just found your initial comment useful for what I wanted to say.)
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I should not comment because I am one who got lucky genes -- at least in the body type department. But man, I have watched a dear friend go through so much crap with doctors who won't BELIEVE her when she describes her sensible diet and the great amount of exercise she does. She really is very dedicated to her healthy lifestyle, but her body type is her body type. Doctors just blame, lecture, disrespect, and do not offer any real help. It makes me so sad for all the women who go through this. I hope someday it will be common knowledge that being "overweight" is not some indication of a lack of virtue, laziness, etc, and that for many people it can be nearly impossible to lose weight. So I think any reports about weight and cancer should be done very sensitively and acknowledge all the unknowns that people on this thread have pointed out.
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Shetland, agreed.
And the role of hormones in weight regulation needs to be studied a lot more too. It's not as simple as calories in, calories out for a lot of people I personally know.
And then there's the effect age has on at least my metabolism--it's definitely slowed down as I've gotten older which means to maintain my current weight, I have to eat less. At some point, that becomes unsustainable.
But I still don't really see this as body shaming as much as insensitive.
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I am very sensitive to the association between weight and BC. Until my forties I was a healthy weight and at times underweight. Now 20 years later I am considered obese. I am fully responsible for my weight. However I also have a strong family history of BC as my mom, maternal aunt and maternal great aunt had BC.
During my face to face discussions with the BS and MO, my weight was not mentioned. It was a different story with the RO. Due to Covid, the RO was only having phone visits. She called ~30 minutes late and started the conversation by asking “why in the world did I not have a breast reduction since my breasts are extremely large and are probably saggy at my age.” (I'm 63, so yeah, everything is saggy 😀). Then she went on a rant about not liking where the surgeon placed the incision, said I would get lymphedema (which I did), that I needed to go on AI immediately (MO wanted to wait until radiation was complete), have a mammaplasty, do radiation and then have my ovaries removed (I have a genetic mutation that increases my risk of ovarian cancer significantly and increases BC risk as well). She provided no info on the radiation therapy. I was totally humiliated and stunned. I told her I had no plans for breast reduction as I feel it's unnecessary. At the mapping she came into the room briefly but only when I was in the CT machine so I've never actually met her. There were only 5 treatments, so at the conclusion of radiation her colleague came in for the final meeting. The whole experience was just weird. I never went back for a follow up.
I did develop mild lymphedema in my breast and have a seroma in my armpit. I worked up my courage & went to PT which I found helpful. However at the first visit, the PT therapist asked if I was happy with my size? And advised that women she knew that had breastreduction were happy they did it. Again I was stunned and humiliated. At the next visit I explained how humiliated I felt and asked her to respect my feelings. She was very apologetic. I saw her one more time and then we both felt that was sufficient
At this point, I am supposed to have a mammogram this summer and a follow up with the BS in fall. I canceled the next MO follow up. I don't know if I will do another mammogram or any doctor follow up as I do not wish to be humiliated again. My emotional well being is my priority.0 -
I'm sorry that RO was terrible. I hate that bad doctoring would cause you to avoid follow-up care.
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The year my two latest cancers were found, I had a rough bout of flu, my mom died, I had half my teeth pulled, and then the breast and kidney cancers. I lost quite a bit of weight - mostly, it turned out, due to the kidney cancer gobbling up whatever I ate, like a nasty space alien, but also illness, grief, and adjusting to dentures. I quit smoking shortly before the kidney surgery, and then when I started breast radiation shortly after, I was ravenous - I guess it was a combination of not smoking, the cancer being gone, and probably just seeing some light at the end of the tunnel I'd been in that year. When I saw my new PCP the next year, ALL she could focus on was the weight I'd gained, which was all I'd lost plus a few pounds. When I mentioned what all had happened before the gain, she just hand-waved it and said "Look how much you've gained!" like it was the only thing that counted. Now I've lost about half of it, and 2 or 3 sizes, without trying (I usually have to go down to about 800 calories a day to lose) and all she does is congratulate me instead of trying to figure out why. To her, I'm just the fat woman.
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Those are terrible doctors and you should not be treated like that, Alice and Harley.
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edj3
What stinks is this doctor is the new improved one who is so much better than the one I fired after several years! I think she and I just need to shift our priorities enough to meet in the middle somewhere.
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For me, it's like reading the headlines of the latest research, "Women Who Hold Their Breath Less Likely to Have Cancer Recur!"
Filled with hope and great intentions, I hold my breath. Until I can't hold my breath any longer, and the whole experience ends with me gasping and heaving and breathing in more air than I would have, had I continued to breathe normally. Only now I'm filled with guilt and self-reproach.
Interesting research, but I'll keep breathing normally, thanks.
Like some of us have expressed, I can lose weight if I limit my caloric intake to 800 calories daily. It would be incredibly harder and slower than it was when I was thirty, and I would be eternally hungry, headachy, cranky, and sad at missing a slice of cake at birthdays and a burger at barbecues and a glass of wine with friends. And eventually, when I got sick of it, I would give up and slowly gain it all back, plus a few extra.
Or... I can eat a healthy, balanced diet, with occasional (not frequent) treats of dessert and red meat and alcohol, ride my bicycle and walk every day, and move along with my life.
When I had both knees replaced, I started with a orthopedic surgeon who was highly recommended. To avoid wasting time with two surgeries/recoveries/rehabs, I wanted both knees done simultaneously. He refused. "We reserve that approach for our slim patients," he said. I told the office staff I wouldn't be back and picked up my x-rays on my way out the door. I found another orthopedic surgeon who had no problem doing simultaneous total knee arthroplasties. Within three weeks post-op, I was riding my mountain bike around the neighborhood. To assume that carrying around thirty extra pounds makes me stupid or lazy or self-indulgent is a big mistake.
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Alice- your doctors comments are unacceptable. There are times I think the doctors are not even listening. I know they are busy, but I feel like they see so many patients thateveryone sounds alike. So they zone out and are thinking of the next point they want to make. Good luck
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I guess one of the things that stings is the assumption that for some of us it's easy & that people commenting positively on the original post must be the lucky ones for whom it's easy. Nobody ever seems to give any credit to people for whom it's not easy. I DON'T have easy stay slim genes. I'm short, stocky & prone to putting on weight unless I work stupidly hard to stay at normal BMI. But it seems it's not ok to say that because then someone gets upset that it's a judgement on them because I do it. I mean, we have to be able to talk without everyone's emotions getting in the way.
but I'll give my emotion: I'm angry and hurt that nobody ever gives me credit for staying normal BMI. I'm fundamentally lazy, my ass is stuck to the couch, and I would eat empty carbs all day if I could. I exercise and eat well in spite of myself. I did it before I got cancer, I did it extra hard after I finished treatment for stage 1 tnbc because it's one of the few things that showed some potential for lowering risk of recurrence. It didn't work but I'm *still* doing it now because it might extend my life & it definitely makes me stronger to endure treatment. Every frigging bone in my body hurts and all of me is fatigued and I did zumba today after being on taxane chemo for over a year. I have too much fat, not enough muscle & I keep trying to fix it, no matter how hard it is but nobody recognizes that or gives those of us who try it any credit at all.
(jeez maybe this should be in the steam room thread but I'm just going to post here)
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Moth, I only wish we lived in the same city. You are amazing
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moth, I totally get it. I work hard to keep my weight in check. My all time high weight was in 2010 and I used an app to count calories and lost 23 pounds. It was hard, but I did it.
The last time my weight dropped was when I had pneumonia and "couldn't eat" - believe me, that has NEVER been a problem. Now, my weight has crept up about 10 pounds since I was diagnosed with Stage IV and COVID started. It's slowly coming off, but I really have to watch what I eat.
I tried intermittent fasting for a day, with no results - haha. Actually, I've been sticking with it pretty well. I just wish it were easier. My husband is fit and eats healthy. He runs/surfs/rock climbs every week. He's super sweet and supportive of me.
I track my weight on an Excel spreadsheet - I know, I know, but it works for me. It's kind of fun to track trends, or to look back and see how much a weighed a year ago, or how long it took to lose the 23 pounds. I know the weight where I feel the best, but sometimes I just want to say the heck with it. Sigh...
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Moth, thanks and I am right there with you. And I will give you some praise! In fact, I’m giving you a standing ovation right now. And if your care providers aren’t giving you positive feedback for making the effort, shame on them.
I struggle to lose and maintain. It IS hard, no question. I also have to restrict calories to around 1000 to even lose anything. But my knees and feet are thanking me for getting out of the obese BMI range in 2017. Probably my pancreas is too.
My cardiologist definitely wants me to lose more and be active although he hasn't said much lately, since COVID has made it harder to be active. I have hypertension and I'm a bit skeptical that weight loss would change it that much because I was a healthy weight and in my thirties when it started. But I know my doctor has my health in mind so I don't fault him for bringing up the issue and maybe he does know a little more than I do, right?
Anyway, we're all free to do as we please, I don't judge anyone for their choices and I do understand how hard it is to lose. But if evidence shows a link between behavior and disease, I want to know about it. I expect researchers and doctors to inform me. What I do with the info is up to me.
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