[AlaskaAngel]

Risk management in regard to breast cancer is skewed.

Each of us is at some percentage of risk for recurrence, and the recommendations for treatment are based upon that risk.

They know that weight gain adds risk. They know that menopause slows the metabolism, and along with the lowering of hormonal levels of testosterone (which had been helping to sustain more muscle tissue and less fat tissue) that comes with menopause, plus the repeated periods of feeling ill, plus the contribution by steroid use during chemotherapy... contribute to weight problems.

But that risk is never added into the calculation in estimating risk in the first place.

So, the effect is that treatment is given to reduce the risk for recurrence by "x" amount....

And then that treatment causes weight gain that then increases the risk by "?" amount.

What I'd like to know is, how many people are going through treatment for a benefit that is then zeroed out by the weight gain? Or even worse, how many would possibly be recurring because the weight gain adds more risk than the amount of benefit that the treatment provided?

This is one of those never-discussed aspects of considering the pro's and con's of treatment, in part because they "don't know" who is going to gain weight and who is not, due to menopause.

Some people will immediately favor doing chemotherapy anyway, "just to be on the safe side". But without any way to define and understand or calculate the added risk, that is actually mostly a form of positive (or wishful) thinking.

Those who discuss risk with patients at time of choosing treatment blow it off entirely.

In the last few years, some of the cancer centers are starting to finally admit and emphasize the importance of proper weight management during and post-treatment.

I was of proper weight at time of diagnosis, and after treatment it took 6 years after treatment to lose the weight I had gained. As my metabolism continued to slow down even further, all of the weight came back despite doing much greater diet and exercise than I ever did up to age 51.

So as a stage 1 who did treatment, am I at greater risk because I did treatment? About the same risk? Less risk? And where in my medical record can I find that evaluation and calculation done in my behalf?

A.A.