Breast Cancer & Weight Gain: What You Need To Know
Nearly 80% of people who are diagnosed with breast cancer will experience weight gain,1 reported to range between two pounds and 18 pounds. Not only is this an alarming trend for general health and self-image, but also some evidence suggests that pre-menopausal women who gain weight have a 1.5 fold increase risk of cancer recurrence.2 Other studies have shown that some types of treatment, such as anastrozole , are less effective at treating breast cancer in patients who are obese.3
Stephanie Graff, MD, Director of the Breast Cancer Program at Sarah Cannon Cancer Institute at HCA Midwest Health and Associate Director of the Breast Cancer Research Program at Sarah Cannon Research Institute shares what people should know about the risk factors for weight gain after a breast cancer diagnosis.
Simultaneously hitting menopause
Women who become post-menopausal within the year they are diagnosed with breast cancer are the most likely to gain weight. An average woman without breast cancer gains three pounds with menopause.4 The risk of weight gain with menopause is highest in women who were at a healthy weight when reaching menopause. There does not seem to be a significant weight gain in women who quit hormone replacement at the time of a breast cancer diagnosis.
Emotional wellness & coping skills
How The Study Was Done
To do the study, researchers analyzed survey results from 309 women living in Australia who had been diagnosed with breast cancer. The survey was done online between November 2017 and January 2018. The characteristics of the women who completed the survey:
- 92.5% were white
- the average age was 59.1 years ages ranged from 33 to 78
- the average age at diagnosis was 50.9 years
- 43% were premenopausal and 12% were perimenopausal when diagnosed
- 10.7% were diagnosed with ductal carcinoma in situ
- 82% were diagnosed with stage I to stage III breast cancer
- the average time since diagnosis was 8.2 years
- 18.8% were treated with tamoxifen alone
- 47.3% were treated with other hormonal therapy medicines
- 40.5% were taking hormonal therapy medicine when they completed the survey
Causes Of Weight Gain With Chemotherapy
The reasons a patient may gain weight while receiving chemotherapy include:
- Chemotherapy may cause swelling , leading the body to retain extra fluid. This is also known as fluid retention or lymphedema.
- You may feel hungrier while undergoing chemotherapy, or you may feel nauseous and then relief when you eat.
- You may be exercising less because chemotherapy causes you to feel fatigued.
- Chemotherapy may cause menopause in some women, which may lead to a decrease in metabolism.
- Certain types of cancer, such as ovarian cancer, are associated with weight gain.
- Your doctor may prescribe steroid medication during chemotherapy treatment. Steroids may help lower inflammation and treat nausea. However, steroids also may increase your appetite and fullness in the abdomen, face and neck.
- For breast, prostate, testicular or uterine cancer, you also may receive hormone therapy. These therapies may lower the amount of estrogen or progesterone in females and testosterone in men. Lowering these hormones may cause you to increase fat while lowering your metabolism and muscle mass.
- A cancer diagnosis may lead you to feel more stress, and that may prompt you to eat more and put on weight.
Be sure to schedule regular checkups and screenings for other conditions while youre on chemotherapy, such as diabetes or high blood pressure, as they may also be related to weight gain.
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Stopping The Ovaries Working
In premenopausal women, doctors might use a type of hormone treatment to stop the ovaries from producing oestrogen. This type of drug is called a luteinising hormone releasing hormone . For example, goserelin and leuprorelin . You might have this on its own or with other hormone therapy drugs.
LHRH drugs work by blocking a hormone made in the pituitary gland that stimulates your ovaries to make and release oestrogen. This stops your ovaries from working. So you won’t have periods or release eggs while you are having the injections.
When you stop taking the drug, your ovaries should start working again. But, if you’re close to the age at which your menopause would naturally start, your periods might not start again.
What Cancer Treatments Can Cause Weight Gain
Cancer treatments such as chemotherapy, steroid treatment, and hormone treatments can lead to weight gain in different ways.
Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can lead to weight gain by:
Causing the body to hold on to excess fluid, called edema.
Causing fatigue, making it harder to exercise.
Increasing nausea that improves by eating more food.
Triggering intense food cravings.
Lowering your metabolism. Metabolism is the rate that the body uses energy. When your metabolism is low, you burn less calories, which can make you gain weight.
Causing menopause, which also slows down your metabolism.
Steroid medications. Steroids are prescribed during cancer treatment for several reasons. This type of medication can reduce symptoms of inflammation, such as swelling and pain. They can treat nausea. And they can be used as a treatment for cancer itself, such as for multiple myeloma.
A common side effect of steroids is weight gain. Steroids can lead to weight gain by:
Increasing your appetite and making you eat more.
Increasing fat tissue in the abdomen, neck, face, or other areas with long-term use.
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If Youre Overweight Aim For Controlled Weight Loss
With two-thirds of the American population classified as overweight or obese, many newly diagnosed cancer patients who fall into those categories consider the prospect of treatment-related weight loss to be a silver lining. But its not your ticket to become the Biggest Loser, Ms. Stella and Ms. Gerdes say.
We want to make sure theyre not losing in an uncontrolled manner, Ms. Gerdes says, noting that rapid weight loss usually involves the loss of lean muscle mass, which is needed to maintain strength. Losing five to six pounds a week would be concerning.
Hormonal Therapies For Breast Cancer
Hormonal therapy is used to treat breast cancers that are hormone receptor positive. These cancers have receptors for the hormones oestrogen and/or progesterone they are called ER and/or PR positive cancer. Around 70% of breast cancers are ER positive.
Hormonal therapy may be recommended after other treatments for breast cancer like surgery, chemotherapy or radiotherapy. Sometimes it is used to shrink breast cancer before other treatment is given. The aim of hormonal therapy is to starve breast cancer cells of the hormone that makes them grow. This lowers the risk of breast cancer coming back or a new breast cancer developing in the treated breast or in the other breast.
There are several different types of hormonal therapies. Some are taken as tablets and others may involve surgery, injections or radiotherapy to turn off ovaries in premenopausal women.
This brochure explains the following types of hormonal therapies to turn off ovaries in premenopausal women:
Hormonal therapies can also be used to treat ductal carcinoma in situ and to reduce the risk of breast cancer in women with a strong family history or other risk factors for breast cancer.
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Exercise Muscle Mass And Weight Gain
Changing your diet and being more physically active may help you to maintain your normal weight.
Physical activity can help to maintain muscle strength, but it needs to be a combination of aerobic and resistance exercise.
Aerobic exercise is any exercise that makes your heart and lungs work faster to provide more oxygen to the muscles for example walking or gardening.
Resistance training includes weight training and swimming. You have to use your muscles to push against the weights or water, which helps to strengthen them.
Physical activity also helps to control your weight. You dont have to go to the gym, you can build it into your life. For example, you could get off the bus the stop before you need to, do some gardening or join a walking group. Some hospitals organise exercise sections for cancer patients. Ask your specialist nurse if this is available.
You should aim to be physically active for 30 minutes 5 days a week. Your doctor may check your cholesterol and heart health before you start an exercise plan. This is important if you have conditions such as diabetes or you are overweight.
Hormone treatment may lower your bone density, increasing the risk of fractures. Talk to your doctor if this could be a problem for you.
Eating a balanced healthy diet can help you to maintain a healthy weight. It can also help you lose or put it on if you need to.
This page is due for review. We will update this as soon as possible.
If Youre Getting Radiation Therapy To The Abdomen
If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:
Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.
These problems should get better when treatment is over.
Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.
If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.
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Menopausal Hormone Therapy And Cancer Risk
For decades, women have used hormone therapy to ease symptoms of menopause, such as hot flashes and sweating. This is called menopausal hormone therapy, and you may see it abbreviated as HT or MHT. You may also hear it described as hormone replacement therapy , postmenopausal hormone therapy , or postmenopausal hormones .
In the past, many doctors and their patients believed that MHT didnt just help with hot flashes and other symptoms it had important health benefits. But well-conducted studies have led many doctors to conclude that the risks of MHT often outweigh the benefits.
This information covers only how MHT can affect a womans risk of getting certain cancers. It does not cover other possible risks of MHT such as heart disease or stroke.
You can use this information when you talk to your doctor about whether MHT is right for you.
Weight Gain After Breast Cancer Diagnosis May Be A Bigger Issue Than Thought In Australia
- Tags:Obesity, Early-stage: Stage IIIA, Early-stage: Stage IIB, Early-stage: Stage IIA, Early-stage: Stage IB, Early-stage: Stage IA, and Early-stage: Stage 0 — DCIS
Gaining weight after being diagnosed with breast cancer may be a bigger problem than previously thought, and doctors need to do more to help women manage this weight gain, according to a study done in Australia.
The research was published on Feb. 20, 2020, by the journal BMC Cancer. Read Weight before and after a diagnosis of breast cancer or ductal carcinoma in situ: a national Australian survey.
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If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
How Long Do I Take Tamoxifen
The American Society of Clinical Oncology recommends that:
- newly diagnosed premenopausal and perimenopausal women take 5 years of tamoxifen as their first hormonal therapy after this first 5 years is done, the hormonal therapy taken for the second 5 years would be determined by the womans menopausal status:
- postmenopausal women could take another 5 years of tamoxifen or switch to an aromatase inhibitor for 5 years
- pre- and perimenopausal women would take another 5 years of tamoxifen
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How Much Hormone Therapy Costs
The cost of hormone therapy depends on:
- the types of hormone therapy you receive
- how long and how often you receive hormone therapy
- the part of the country where you live
Talk with your health insurance company about what services it will pay for. Most insurance plans pay for hormone therapy for their members. To learn more, talk with the business office where you go for treatment. You can also go to the National Cancer Institute database, Organizations that Offer Support Services and search “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for help.
How Sex Might Be Affected
With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.
For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.
For men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in Sex and Men With Cancer.
If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex
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Potential Interventions To Avoid Weight Gain
The dose of physical activity required to offset the deleterious effects of diagnosis and treatment on body weight and adiposity is not well characterized in cancer patients but evidence from the general population suggests it is not trivial. Women in the National Weight Control Registry, a database of over 6000 people report close to an hour of physical activity a day an Institute of Medicine report generally concurred with that recommendation. A well-controlled study by Jakicic et al demonstrated that women who performed less than 240 min of exercise per week slowly regained lost weight over the course of a year. An important consideration to prescribing an effective dose of exercise is the degree of compensatory behavior in terms of greater inactivity and increased energy intake.
Nissen and colleagues found that exercise was a stronger predictor of weight change during chemotherapy than energy intake. Goodwin and associates found that weight gain could be prevented in a group of 61 breast cancer patients with BMI of 20-35 kg/m2 however, weight loss required a combination of caloric reduction and exercise.
Does Cancer Treatment Cause Unwanted Weight Gain
Weight loss is a common side effect of some cancer treatments. But sometimes, the opposite happens and patients end up packing on the pounds instead of losing them.
So, what causes involuntary weight gain in some cancer patients? And what can patients and their physicians do to counteract this unexpected side effect?
We spoke with integrative medicine specialist Wenli Liu, M.D., to learn more. Heres what she had to say.
What are the most common causes of involuntary weight gain during cancer treatment?
There are actually several, but the biggest is probably steroids. These are prescribed to prevent inflammatory and anaphylactic reactions to chemotherapy, to reduce swelling in patients with brain tumors, and as a cancer-fighting agent used to treat cancers such as lymphoma/myeloma. The downside is that steroids also act as a major appetite stimulant, which can spur overeating.
Another common cause of involuntary weight gain is hormone-suppressing treatments, such as those received by patients with breast cancer or prostate cancer. Hormones have a tremendous effect on metabolism. Hormonal treatments for breast and prostate cancer can result in involuntary weight gain.
The third example is fear: the fear of losing weight. Sometimes, patients are so afraid that theyll become emaciated or unable to eat that they force themselves to do so while they still can, even when theyre not losing weight at all. Over time, that can lead to weight gain, too.
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