Breast Cancer And Weight Gain An Unexpected Finding

A Lump In Your Breast

While checking for a lump in the breast is probably the most well-known way to check for breast cancer and research has shown that a large portion of breast cancer survivors found their own breast cancer either through a self exam or by accident it may not always be clear what a woman should be checking for.

The team at Breastcancer.org suggests performing a breast self exam once per month to get used to how your breasts normally feel. That way, if you feel something out of the ordinary, you’re more likely to know. Another important thing to note is that “lump” can be a confusing way to describe what you’re looking for. While this may make it seem like you’re looking for something shaped like a marble, lumps in the breast can range from spherical shaped, to a general “thickening” of the breast tissue. That’s why it’s important to know what your breasts normally feel like so you can tell if anything suddenly feels off.

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.

Why Does Metastatic Breast Cancer Happen

Most often, metastatic cancer occurs because treatment didnt destroy all the cancer cells. Sometimes, a few cells remain dormant, or are hidden and undetectable. Then, for reasons providers dont fully understand, the cells begin to grow and spread again.

De novo metastatic breast cancer means that at the time of initial diagnosis, the breast cancer has already spread to other parts of the body. In the absence of treatment, the cancer spreads.

There is nothing you can do to keep breast cancer from metastasizing. And metastatic breast cancer doesnt happen because of something you did.

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How Can I Take Care Of Myself While Living With Metastatic Breast Cancer

Living with metastatic breast cancer can be challenging. Your care team can help provide physical and emotional support. Talk to them about how you can:

• Eat the most nutritious diet for your needs.
• Exercise regularly.
• Get emotional support, including finding support groups.
• Reach out for help from friends, family and loved ones.
• Find mental health services.
• Find complementary therapies.

Body Weight And Breast Cancer Risk Before Menopause

Women who are overweight or obese before menopause have a 10-20 percent lower risk of breast cancer than those who are lean .

Although being overweight or obese is linked to a lower risk of breast cancer before menopause, weight gain should be avoided. This is because any weight gained before menopause may be carried into the postmenopausal years and most breast cancers occur after menopause.

After menopause, being overweight is linked to increased breast cancer risk.

Hormone receptor status

Women who are overweight or obese before menopause have a lower risk of overall breast cancer than those who are lean .

However, some findings suggest women who are overweight or obese may have an increased risk of estrogen receptor-negative breast cancers before menopause, including triple negative breast cancers .

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Can Metastatic Breast Cancer Go Into Remission

Metastatic breast cancer may never go away completely. But treatment can control its spread. Cancer may even go into remission at some points. This means you have fewer signs and symptoms of cancer.

A treatment break may be considered in certain situations, including if remission occurs or if someone is experiencing intolerable side effects. A pause in treatment can help you feel your best and improve your quality of life.

Find Support If You’re Diagnosed

While not a symptom of breast cancer, feelings of fear and loneliness may occur after being diagnosed. And there are countless resources online for finding a support group of other people who have been diagnosed with breast cancer. Find one of those support groups and connect with people who understand what you’re going through.

There are even some therapists who specialize in treating those who have been diagnosed with cancer and other diseases. Remember, while breast cancer is scary, there are viable treatments available…and you don’t have to fight it alone.

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Weight Gain After Menopause

Its not just the weight a woman gains after age 18 that seems important to risk. The weight a woman gains after menopause also appears to be linked to an increased risk of breast cancer .

One large study showed women who gained 20 pounds or more after menopause had an 18 percent higher risk of breast cancer compared to those who gained little or no weight after menopause .

How Is Metastatic Breast Cancer Diagnosed

If you have symptoms of metastatic breast cancer, your provider may recommend tests including:

• Blood tests, including complete blood count and comprehensive metabolic panel.
• Imaging studies, including MRI, CT, bone scan and PET.
• Bronchoscopy, which uses a scope to look inside your lungs this can be done if there is a concerning spot in the lungs.
• Biopsy to remove tissue from a suspicious area and analyze it.
• A tap to remove fluid from an area with symptoms. For example, pleural tap removes fluid from the lung area. Spinal tap removes fluid from the spinal cord area.

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Changes In Bowel Movements

If you’re finding yourself suddenly constipated, be sure to take note of any other symptoms. A study back in the ’80s found an association between women who are constipated and an increased risk of breast cancer. Then, a study in 2008 found that women who had three or more bowel movements per day had a 46 percent decreased risk of developing breast cancer compared to women who had only one bowel movement per day.

While there hasn’t been much conclusive research since then to determine if constipation was a symptom of breast cancer or if something else in the body is related to both frequent constipation and breast cancer, if you’re noticing changes in how often you go to the bathroom, talk to your doctor.

Ethics Approval And Consent To Participate

The protocol was approved by the Independent Scientific Advisory Committee of the MHRA . Ethics approval for observational research using the CPRD with approval from ISAC was granted by a National Research Ethics Service committee . The CPRD has broad National Research Ethics Service Committee ethics approval for purely observational research using the primary care data and established data linkages. The study was performed in accordance with the Declaration of Helsinki.

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Risk Of Cancer Diagnosis Following Presentation With Unexpected Weight Loss

Over the 2 years, the risk of a cancer diagnosis was higher in patients with unexpected weight loss than controls in the three months after the index consultation, but thereafter, the risk of cancer was lower than controls . The same pattern was observed after adjustment for potential confounders and after taking into account matching in the first and second sensitivity analyses . Expressed as the cumulative hazard of cancer, 1.2% of patients with unexpected weight loss and 0.5% without unexpected weight loss had been diagnosed with cancer in the first three months after the index consultation, a difference that narrowed to 1.6% and 1.5% by 9 months and then inverted to 1.8% and 2.0% by 12 months .

Fig. 2: Risk of cancer diagnosis over time.

Univariate smoothed hazard rate and cumulative hazard of cancer diagnosis by unexpected weight loss status.

Let’s Talk About Carbs

Assuming that youve discussed daily calorie needs with a professional, especially if weight loss is a goal, then the spotlight needs to be on grains. This food group needs special attention because processed carbohydrates have overwhelmed the American diet. Choose whole grains as the primary ingredient and make sure the ingredient list is short. Labels should say 100 percent whole wheat or the unprocessed grain should be the first and primary ingredient. Use portion control and decide how many portions to have daily.

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Best Exercises: Part 2

Resistance training builds muscle. Start with light weights and consider using elastic bands, which come in a variety of resistances. Insurance may cover workouts with a physical therapist. If so, as you wrap up that relationship, make sure you create some programs you can follow on your own. Find out if there are MBC-specific exercise and wellness programs close by or at a local hospital. For example, the JCC Manhattan in conjunction with Mount Sinai and BreastLink New York has a robust program.

Body Weight And Breast Cancer Risk After Menopause

Women who are overweight or obese after menopause have a 20-60 percent higher breast cancer risk than those who are lean .

Being overweight or obese after menopause is linked to an increased risk of both estrogen receptor-positive breast cancers and estrogen receptor-negative breast cancers .

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Other Drugs Used For Menopausal Symptoms

Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.

Antidepressants

The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .

Gabapentin

Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:

• Drowsiness

What Are The Risks Of Gaining Or Losing Pounds

Weight gain can raise your risk for getting high blood pressure, heart disease, and diabetes. Being overweight also puts you at risk for getting other types of cancers. 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.

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Specific Demographic Medical Menopausal And Lymphoedema Details Requested In The Survey

Demographic characteristics.

State of residence, highest level of education, ethnicity, employment status, relationship status, current age and age at diagnosis were included to describe the characteristics of women.

Medical details.

Women were asked about their diagnosis, treatments received including treatments received to the axilla, the number of lymph nodes removed, whether they had a reconstruction, use of hormonal treatments, menopausal state , presence of other medical conditions and symptoms such as hot flushes and the presence and severity of lymphoedema.

Women were asked to describe the type of breast cancer they were diagnosed with as either ductal cancer in-situ , localised stage breast cancer , metastatic breast cancer or inflammatory breast cancer. For convenience, inflammatory breast cancer and metastatic breast cancer were then combined and referred to as advanced breast cancer. Women were also asked to indicate the treatments they received such as Lumpectomy alone, Lumpectomy and radiation, mastectomy alone, mastectomy and radiation, removal of lymph nodes, chemotherapy, hormonal therapy, targeted therapy , and other. As chemotherapy is invariably not provided to women with DCIS, we recoded the diagnosis as localised if a woman indicated that she had received chemotherapy.

Lymphoedema severity was defined as either no problem , mild , moderate , severe as described elsewhere .

Lifestyle habits.

Weight management.

What This Means For You

As many of us know, trying to lose weight especially as we get older can be hard and frustrating.

Still, it can be done with careful changes to your diet and regular exercise. The first thing to do is to talk to your doctor about a healthy weight for you based on your age, height, body type, and activity level. Then ask your doctor about a safe and sensible plan to lose weight that is specifically designed for you and your needs.

Once you have the OK from your doctor and a weight goal, you can create a healthy eating plan that meets your nutritional needs. You may want to talk to a registered dietitian about how to create a healthy eating plan thats tailored to your specific needs and likes.

Some women say that it helps to think of eating well and exercising as important parts of their treatment plans. Remember to be nice to yourself dont punish yourself.In the Breastcancer.org Nutrition section, the pages can help you assess your weight and create a healthy eating plan. And the Breastcancer.org Exercise pages can help you find a trainer and learn how to stick to an exercise routine.

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Cough Or Hoarseness That Doesn’t Go Away

Some symptoms of breast cancer may indicate that the disease has progressed. These may be symptoms of any form of cancer, but because breast cancer is so common among women, and may go undiagnosed for quite some time, they’re important to mention.

One sign that something may be going on is if you have a persistent cough or hoarseness that doesn’t go away. This could mean that breast cancer has spread to your lungs, which Breastcancer.org notes is one of the most common places for breast cancer to spread.

Diet And Nutrition: Part 2

Aim to eat lean and mostly plant-based proteins: skinless chicken and turkey, eggs and egg whites, beans, nuts, seeds and legumes, tofu, tempeh, low fat Greek yogurt, and bean-based pastas. Choose wild fish and cook simply. Try heart-healthy fats: unprocessed nuts and nut butters, olive oil, and avocado. Limit coconut oil use. As for soy, less processed is better, and aim for no more than 3 servings daily. Check with your doctor regarding soy consumption.

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Contour Temperature Or Texture Changes

Changes in your breast, such as to the contour, temperature, or texture, can be a sign of a type of breast cancer known as inflammatory breast cancer. While the National Cancer Institute reports that this type of rare breast cancer accounts for just one to five percent of breast cancer cases, it is aggressive so if you’re noticing its symptoms, it’s especially important to see your doctor.

Your breast may appear red and inflamed or may even look dimpled or pitted, like the skin of an orange. The National Cancer Institute says this type of breast cancer is more common in women who are overweight or obese and is more likely to occur in young women.

Getting Help For Depression

Depression can be treated. Below are common signs of depression. If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment. Be aware that some of these symptoms could be due to physical problems, so it’s important to talk about them with your doctor.

Emotional signs:

• fatigue that doesn’t go away
• headaches, other aches and pains

If your doctor thinks that you suffer from depression, they may give you medicine to help you feel less tense. Or they may refer you to other experts. Don’t feel that you should have to control these feelings on your own. Getting the help you need is important for your life and your health.

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Association Of Prediagnostic Bmi With Survival

Survival after breast cancer diagnosis among premenopausal and postmenopausal women by BMI group 1 year before diagnosis was evaluated using the Kaplan-Meier method. Premenopausal women who were obese 1 year before diagnosis had significantly lower survival than nonobese patients . At 5 years after diagnosis, 83.6% of obese women were alive compared with 93.7% nonobese women. Using Cox proportional hazards models adjusted for age at diagnosis and history of hypertension, the HR for those who were obese compared with those considered of ideal weight 1 year before diagnosis was 2.85 for breast cancerspecific death and 2.62 for overall death . The risk of breast cancer death increased by 7% for each unit increase in BMI . Similarly, weight at 1 year before diagnosis was associated with increased risk of death due breast cancer and overall causes among premenopausal women when comparing the highest versus lowest quartile of weight .

Figure 1.

When comparing patients by BMI group among postmenopausal women, obese women did not have significantly different 5-year survival rates than nonobese women . However, obesity 1 year before diagnosis was associated with an increase in breast cancerspecific mortality and for all-cause mortality when compared with ideal weight women.