[AlaskaAngel]

Tanya, I have a breast cancer specific question related to obesity.

My problem continues to be the one problem that no one acknowledges for those like me who are over 55, some years out from treatment and gradually becoming more and more postmenopausal -- the problem of how to successfully deal with completely unavoidable interruptions in diet and exercise.

My 1,000 calorie a day diet and my full hour a day of exercise now are not producing actual weight loss. Those things are what I have to do just to avoid gaining more weight.

Today is an especially good example of this problem. On rare occasion I have significant vertigo, which is what I have today. There is no way I can do a 3-miler today, nor can I do resistance exercises. Since diet and exercise is only resulting in weight maintenance for me and not weight loss, what am I supposed to do today? Not eat at all and wait to feel better so that I won't gain weight? Or eat something today, and gain weight that I then am unable to lose? Or do I reschedule everything whenever these things happen and "double" my amount of exercise (but not double what I eat) for several days everytime this happens on a completely unpredictable basis?

What would you do?

This is why I question whether doing chemotherapy is helpful in a group of patients who are almost entirely unlikely to recur in the first 10 or so years. Doing the chemo makes a little more sense for those who are under age 50 and still premenopausal. For older women (who clearly are the majority of breast cancer patients), the chemotherapy "stalls out" metabolism for those who are older, and then results in more intractable weight gain that then increases the risk of recurrence. What is the point of doing the chemotherapy in that group of women if it puts them back at high risk?

That is why I would like to see if drugs like trastuzumab used alone in that group would result in a lower recurrence rate, or not.

I feel sorry for those who are under 50 and premenopausal because it would seem logical that if the chemotherapy plus trastuzumab does work and they do not recur, it seems logical that they will eventually have the same problem with weight management that I am having despite consistent diet and exercise.

AlaskaAngel