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Many women expect to become thin and gaunt if they have breast cancer, but medical treatment can actually promote weight gain in some women.
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msnbc.com contributor
updated 10/8/2008 8:35:20 AM ET 2008-10-08T12:35:20

It’s common knowledge that keeping fit and maintaining an optimal weight are great ways to achieve overall health. But for breast-cancer survivors, the stakes are much higher.

Research indicates that excess weight can lead to increased levels of the hormone estrogen — and estrogen has been tied to the development of breast cancer in women.

Dr. Duc Vuong, a weight-loss surgeon in Houston, spells out the issue plainly.

“Overweight women have larger breasts,” he says. “These women have more exposure to estrogen, which we think increases their risk of several different cancers, including breast and uterine cancer.”

Vuong says more women are beginning to recognize the connection between excess weight and cancer, and that’s prompting them to take action.

Women on the move
After her second breast-cancer diagnosis two years ago, Ilya Sloan, who was then in her mid-60s, realized that the 200 pounds she carried on her short frame could have played a role in her getting the disease. Her oncologist told her about a clinical research weight-loss study at the Arizona Cancer Center, where Sloan works as a community events coordinator.

By the time she completed the six-month study, Sloan had lost 40 pounds on a low-carbohydrate and low-calorie diet. (The study also included participants who followed low-fat and low-calorie dietary regimes.) As part of her goal to drop more pounds, Sloan does water aerobics several times a week.

Sloan says she’s thrilled that her results are “concrete, something you can see.”

Tawny Rohrbaugh, 45, of Ashland, Ohio, didn’t learn about the connection between excess weight and breast cancer until after her diagnosis in August 2007. As soon as she grasped the seriousness of the situation, she made a decision.

“No more messing around,” Rohrbaugh remembers thinking. “It could mean my life if I don’t lose weight.”

Before her diagnosis, Rohrbaugh had already lost 60 pounds as part of a weight-loss plan — and then chemotherapy caused her to gain back half that amount. But after making a self-directed lifestyle change — which she describes as “cooking healthy food” with lots of fresh fruit and vegetables and regularly doing Pilates-based workouts — Rohrbaugh has lost that weight and continues to drop between 2 and 3 pounds a month.

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Rohrbaugh says her motivation is strong: “I don’t want to go through cancer a second time.”

Sheri Morris, a registered nurse with a family history of breast cancer, decided to take an extreme step to lose excess weight. About a year and a half ago, Morris, then in her late 30s, went on a liquid meal replacement plan and lost 35 pounds. Now she tries to hit the gym two or three times a week.

Morris works for Vuong, the Houston surgeon who specializes in laparoscopic adjustable gastric banding, or lap-band surgery. She notes that even women who have had weight-loss surgery must be vigilant.

“Weight-loss surgery’s a tool, but women must still make healthy choices,” she says.

Not the easiest time to lose weight
Dr. Susan Love, a former breast-cancer surgeon who is now president of the Dr. Susan Love Research Foundation, says pre-menopausal women who have had breast cancer and are obese have a higher risk for recurrence. Post-menopausal women are at risk as well.

“We do not know exactly why, but one hypothesis is that fat is capable of making estrogen post-menopausally,” says Love, who notes that it’s simple math — lower the amount of fat and body weight, and you lower the amount of estrogen circulating in the body.

While most women would agree that losing weight is tough under any circumstances, those fighting breast cancer have a different and overwhelming priority — to get through their treatment. Being pushed to lose weight during this critical time is often jarring. “It’s adding insult to injury,” says Sloan, the woman who lost 40 pounds in the weight-loss study.

Love agrees this is a sensitive issue. “It’s not the best thing, as a woman leaves the hospital, to yell, ‘Lose weight!’” she says.

Slideshow: Famous breast cancer survivors Other challenges can emerge for women at this time, says Emily Nardi, a registered dietitian who counseled participants in the Arizona Cancer Center’s weight-loss study. The study used a screening process to determine patients’ “state of readiness” to lose weight as a condition for enrollment.

Nardi explains that many women expect to become thin and gaunt if they have cancer, but medical treatment can actually promote weight gain in some women, as happened with Rohrbaugh. Depression also can become a debilitating problem for some breast-cancer patients — including young women thrown into sudden menopause. And, Nardi adds, the hormonal shift during menopause also can contribute to unexpected weight gain.

“During and after treatment, women are often inactive and they want to be nurtured and comforted,” Nardi says. “And comfort can often be found in food.”

Overcoming obstacles
How can a woman with breast cancer make it past these hurdles?

Love stresses that empowerment is key. In her lectures, she underscores “losing weight and exercising are actions that each woman can take” to lessen the chances of recurrence.

Sloan says it’s important to be held accountable — a reference to the weigh-in periods that were part of her weight-loss study and that women also can do at home.

The fear of a recurrence never goes away, Sloan says — but she gains strength knowing that, by losing weight, she’s increasing her odds of survival.

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