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Risk of Second Cancer Goes Up as Weight Increases

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Comments

  • salamandra
    salamandra Member Posts: 719
    edited April 2021

    Just to clarify, this study isn't showing evidence of a link between a behavior and a disease, it's showing evidence of a correlation between size and a disease. Those are very different things, and conflating them is part of the problem that leads to confusion and needless pain. Being fat is not a behavior. Exercising (or not) is a behavior, eating certain things/quantities (or not) is a behavior. But being fat or not fat is not a behavior.

    Without studies that show the impact of calorie restriction/weight loss specifically, interpreting this one study as a reason to lose weight or applying it to an individual is like trying deciding to bleach one's skin because white women have lower mortality for your type of cancer...

  • olma61
    olma61 Member Posts: 1,016
    edited April 2021

    Are you saying there isn't a link between calorie intake and body fat or size? Are there studies that show how common is the condition of being obese and not being able to change that through diet and exercise?

    I am aware that there are conditions that make weight reduction more difficult. Not aware of how common it is to have a condition that makes it impossible


    Here’s a study that showed losing weight causes hormone levels to drop, which is especially relevant to those who have had or might develop hormone positive cancers


    https://www.breastcancer.org/research-news/20120530

  • moth
    moth Member Posts: 3,293
    edited April 2021

    There are plenty of studies on behaviour & breast cancer recurrence as well. "Even women who started exercising only after breast cancer treatment was completed got benefits from the physical activity: they had a 46% lower risk of recurrence and a 43% lower risk of dying compared to women who didn't meet the minimum guidelines." https://www.breastcancer.org/research-news/exercis...:~:text=The%20researchers%20found%20that%20women,t%20meet%20the%20minimum%20guidelines


    We also have had cell research proposing mechanisms for exercise (shear forces in blood stream destroying travelling cancer cells) and diet (fat produces its own hormones which may be disrupting immune system & creating an environment amenable to oncogenesis.

    Really, the only issue I see with the studies is that they're misinterpreted because they're epi studies based on populations not the individual. A study might say 5000 lives will be saved through an intervention but we can't tell *which* 5000 people that applies to. But still if we all did, 5000 fewer would die. (totally random number btw)

    And it's the behaviours of healthy eating and exercising are what keep me from being overweight. I get on the scale, I plan my meals, I count my calories, I wear my fitbit, I do my scheduled exercise. These aren't passive things that just happen to me

    & thank you for the cheers Poppy, Sunshine & Olma.

  • salamandra
    salamandra Member Posts: 719
    edited April 2021

    Yes, there are many studies that show that sustained weight loss is rare.


    And yes, I am saying again that being fat isn’t a behavior and it’s not helpful to conflate it with a behavior.

    If there is a behavior you want to focus on - like caloric intake, exercise, etc, then let’s speak of that. This study does not and it certainly does not establish losing weight (how much? Keeping it off for how long?) will lead to better outcomes for women. The study found that there are perhaps up to 7% of cases where there is a correlation with body size. You can claim that the action of dieting will reduce risk if a person falls into that 7% but that is by no means supported by this study.

    Using body fat as a proxy for behavior has caused a lot of harm - harm that is documented for example by studies of the quality of health care received by fat people.

  • moth
    moth Member Posts: 3,293
    edited April 2021

    Ok. I'm going to bow out. I just linked to a study about behaviour.

    If nobody acknowledges the hard things those of us who are not fat do to stay not fat, that's a harm.

    I have no sense of taste anymore so eating healthy is hard. I have neuropathy in my toes, lung damage from radiation for a metastatic tumor in my lung, and I still struggle up 3x/week to do aerobics & I do my daily walks. I get on the scale, I log my calories, I plan my meals.

    None of this is passive. It's behaviour & it's hard & I expect my health care providers to acknowledge it, to support it, to celebrate it. Not to just ignore it, or ignore the studies that show it's beneficial or just assume I'm doing it because I like to or it's somehow easy for me.

    Anyway, maybe my story will inspire someone. Behaviour change is possible, hard behaviours are possible, the benefits of good eating & exercise are countless - not just for cancer but for heart health, joint health, mental health. Baby steps, something is better than nothing, it's all worth it.

  • harley07
    harley07 Member Posts: 247
    edited April 2021

    Moth - I’m sorry your healthcare team doesn’t acknowledge your efforts- they should. I admire people who do count calories and exercise

    In my case, I admit I’m fat and it’s my responsibility. My point is we don’t know what caused my BC. I have a RAD51D mutation and my mom, maternal aunt and maternal great aunt all had BC. So is it my weight that caused BC? My genetic mutation? Or some other unidentified factor? I doubt I’ll ever really know and am not sure it matters.

    In my case, I will not allow myself to be humiliated by my healthcare team again, so at this time, I am not doing any follow up. I reserve the right to change my mind in the future. I am not suggesting or recommending this for any one else.

  • edj3
    edj3 Member Posts: 1,579
    edited April 2021

    Moth, I know it's really hard to lose weight. I posted up thread that it often ISN'T a matter of calories in, calories out (CICO). My dear friend from high school eats far less than I do, despite being 6 feet tall (or as she says, 5 ft 12 inches); I am 5' 4 1/2" and am less than half her size. That right there is a good case study in how losing weight isn't always a matter of reducing calories.

    As I posted earlier, there's a lot of research that needs to be done on the effect of hormones on weight.

  • salamandra
    salamandra Member Posts: 719
    edited April 2021

    I'm sorry your doctors aren't validating your efforts. There are lots of not great docs out there.

    I can see why this study would seem validating to all your hard work.

    I think that is an unsupported interpretation of this study, but I'm just some person from the internet.

    I do know that there is an enormous amount of well-documented discrimination that fat women face on every level, including quality of healthcare. I am very concerned about anything that would perpetuate or increase that.

    Based on the recent studies showing that obese patients get worse care for COVID and that may literally explain almost all of their increased fatality rates, I wonder whether fat discrimination is as much or more to blame for the 7% of poorer health outcomes in cancer as the fat itself.

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited April 2021

    i am slender and walk 6 miles most days. My beloved sister weighs probably 100 lbs more than me and can barely bend down to tie her walking shoes. Guess who got the breast cancer.....


    six years after I was diagnosed, my slender cousin got breast cancer. She has two beloved sisters. One is heavier than the other and the heavier of the two is probably 75 lbs overweight.


    enough! What we don’t need are studies like these. I can think of better research projects..


    we need better screening methods and better treatments and dare I say, a cure!

  • scotbird
    scotbird Member Posts: 592
    edited April 2021

    I've been losing weight over the last 6 months, aiming to get into the healthy BMI range. I've lost about 30lbs and it has been hard as I love food and had got into bad habits.

    Statistics don't mean anything at an individual level, as noted by several people here, luck plays a large part as well, and we can all give anecdotal examples of the marathon runner versus the lifelong bon viveur. I personally find studies like this useful and motivational to nudge me towards healthier behaviour. What and how much I choose to eat is a behaviour. Being overweight is associated with worse health outcomes - that is a hard fact and no emotion, guilt, shame or pride changes that. Same with smoking or drinking alcohol - I've been a smoker in the past and I still like a drink. The anger that comes through in these comments about judging or feeling judged or discriminated against because of being overweight is relevant to this and is very important to acknowledge but I think this is addressing a different point.


    To say that studies are unhelpful if they give us a result that does not fit with our preferred narrative is problematic for me. Prevention is better than cure and research like this may lead to lifestyle changes which lead to lower cancer rates and also might inform further studies which could lead to improved therapies. This is my opinion.

    Definitely not judging anyone here, we are all doing our best and living our own different lives with different struggles and pressures. Unfortunately shame and pride are two sides of the same coin and inextricably linked for me.

  • skv0123
    skv0123 Member Posts: 8
    edited May 2021

    I appreciate everyone’s comments & the insight that fat bias is real.


    I also wonder about the fact that as people gain weight they feel more shame, they often start to get depressed, they may move their body less due to depression & visit the doctor less due to fat bias. Fat shaming in our society causes anxiety, depression & stress. I think the impact of it is ignored.

  • lillyishere
    lillyishere Member Posts: 769
    edited May 2021

    From the title: For Women First Diagnosed With Breast Cancer, Risk of Second Cancer Goes Up as Weight Increases.

    The risk of second cancer goes up from the medications we take as well. On Femara's website there is a risk of second cancer because of this medication. I'm sure radiation, chemo, etc. increases the risk of other cancers. It seems that we can't win. Yikes!

  • edj3
    edj3 Member Posts: 1,579
    edited May 2021

    Lillyishere, I face the same risk with the drug I take for osteoporosis. I'm on Tymlos and that drug can only be taken for two years, maximum, as the risk of a specific type of bone cancer greatly increases after that.

    (I take it because I've had two bones just break on me while running.)

  • moth
    moth Member Posts: 3,293
    edited May 2021

    Lillyishere - the medications & treatments are offered only when their benefit in reducing risk of recurrence is greater than their harms (including their cancer causing potential). & in this study they're comparing women who have had breast ca once & had treatments & are taking the meds. That part gives them all the same risk.

    The study showed that carrying extra weight added extra risk.

    We can win. There is evidence showing which interventions reduce risk of recurrence, again, in a *population*, not the individual.

    I'm imagining a world where part of treatment & survivorship is access to free/low cost fitness & nutrition planning & ongoing monitoring forever after a cancer treatment ends & an expectation that "of course everyone participates". - & we all could grumble about it just like we do about other treatments but we do them anyway, kwim? I think if it was seen as that important, we could shift the recurrence rate ... (& lower the premature death rate from heart disease & stroke & diabetes as a side effect). I don't know - just don't like how weight and exercise recommendations are seen as a luxury add on option instead of being folded into primary treatment plans & as important as anything else.

    I hate exercise so I wish it was cheered on more strongly. Just like I don't want to get in the car to drive to chemo, I never want to put on my running shoes to exercise. But one is viewed as necessary and the other is sort of a well "it's good to do it, try! but we get it if you don't! don't beat yourself up!" & becomes optional. & I don't think it should be. Anyway. That's me right now. I've been battling huge chemo induced fatigue. I sometimes wish I had a personal trainer.


  • salamandra
    salamandra Member Posts: 719
    edited May 2021

    That's such a great insight about exercise Moth.

    I'm also not a big fan. I go through phases when I can do it consistently and phases when I can't. But even aside from help with weight maintenance I do believe that exercise is incredibly healthy both mentally and physically. Yet so hard for some of us to stick with!

    I wonder if employers built in gyms and gave employees work time to exercise, how much they could save on health insurance.

    There is a deal through my health insurance where I can have access to basically multiple chains of gyms for $25 per month (so not necessarily cheaper than any one of these gym memberships would be, but much more flexible). I came so close to buying it but even $25/month is not a bargain unless I actually trust myself to go!

  • rah2464
    rah2464 Member Posts: 1,192
    edited May 2021

    Yeah the exercise thing - I am basically un self-motivated. I have to have someone pushing me to do it. I was always very active living on a farm but not a true exerciser (yet still thin due to genetics). Now I am trying to transform myself to an exerciser so I can be healthier for the next round.

    I agree with your perspective, Moth. We know how impactful good nutrition and exercise is, it just isn't as tempting as laying around and eating cake. Health programs should be part of the treatment plan and accessible for all.

  • edj3
    edj3 Member Posts: 1,579
    edited May 2021

    First, I will cheer any of you ladies on. Come join our exercise thread and post there, just watch me cheer for you!

    And in case this helps (because someone else I told this to said it did)--would you be more likely to exercise if you thought of it in the same way you do as brushing your teeth? Pretty sure you all do that at least once a day, right? Same thing with working out.

  • alicebastable
    alicebastable Member Posts: 1,933
    edited May 2021

    edj3

    When I brush my teeth, my joints don't scream in pain (except for really bad days when my elbow, wrist, and fingers are acting up). I can hang onto the sink when I brush my teeth so my knee doesn't buckle or my foot doesn't roll. When I brush my teeth, I can hunch over the sink long enough to keep my back from hurting too badly to stand.

    I would LOVE to take a brisk walk, but I'm lucky to not trip over my cane or walking stick. And I have to make sure I can sit to stretch my back at certain intervals or it starts hurting like hell. I'd invite those who think starting an exercise regimen would solve all problems to walk a mile in my shoes, but I wouldn't wish that on my worst enemy.

  • moth
    moth Member Posts: 3,293
    edited May 2021

    "I brushed my teeth and still got cavities so what's the point" .... sorry, couldn't resist ....

    I'm on the stage IV exercise thread. Most (all?) of us there are in pain or falling over or rehabbing from falling over/surgery or heavily medicated (hopefully not so heavily that we fall over which is a serious problem in itself) or on permanent chemo or on permanent hormone blockers. It's just hard most days.

  • gb2115
    gb2115 Member Posts: 551
    edited May 2021

    Echoing that exercise is indeed difficult for many many people. I'm about ready to throw in the towel, head over to Ortho and ask "what gives?" Why do my feet and ankles, sometimes knees, sometimes back, feel like they will literally fall apart if I try to move at more than a snail's pace? I'm 42 but feel waaaay beyond my years, and I fully blame tamoxifen. I'm way too young to be debilitated, but I genuinely feel injured most days. I don't want to exercise on a body part that feels injured, for fear of making it worse. What doesn't help is the pelvic organ prolapse that I've mentioned on other threads. We're still in the baby stages of trying to slowly deal with that, so I haven't been cleared yet for exercise other than walking. And walking hurts. Biking, yeah right, not putting a bike seat anywhere near my unhappy lady parts. Swimming is a no-go, not a great swimmer, and water aerobics with a belt would add too much pelvic pressure. Lifting anything other than the lightest of weights is a no-go until the pelvic floor is better.

    What's funny is I'm in a healthcare career that promotes keeping people healthy and exercising and eating well. Now that I've seen things from the other side, it's much easier to meet people where they are without judgment. You can't look at someone who has some pudge and has trouble moving around and assume it's laziness or not caring. Sometimes they are just trying to survive. I get that now.