trends that weight management is going to be important in treating HER2-positive brea - Page 2

Pray · 03-28-2012, 11:56 AM

Angel, I am so sorry your sister has to deal with this too. I'm so glad she has a sister like you to be with her! I have four sisters who I love dearly. None of which has had bc also none of which I have been comfortable with talking about private things. The two I'm closest with we have always had that line drawn. Just the way were raised. Hope and prayers going out to your sis also.

Your friend,

Nancy

Mtngrl · 03-28-2012, 02:26 PM

Does it seem like some doctors have simply given up on the weight issue? Maybe they think it just causes too much stress and unhappiness if they focus on it?

I get weighed every time I go in, but I seem to be the only one paying attention to it. I think they just use it to calculate my Herceptin dose.

Excess weight causes so many other problems. It makes it hard to exercise. It makes the joints hurt. It interferes with sleep. You're right, AA, it's not a vanity thing. It's definitely a health thing.

Good luck helping your sister.

AlaskaAngel · 03-28-2012, 03:15 PM

I think it managing weight gets caught up by health care providers because a) they are dealing with plenty of midriff bulge themselves and feel uncomfortable pointing the finger at someone else who is in denial, or b) they are young and fit and generally clueless about how difficult weight management IS, so they don't relate well to it. Even so, they shouldn't be let off the hook so easily, to where they just push more "miracle" drugs instead of encouraging stronger personal health responsibility.

And some cancer patients want to put aside whatever knowledge there is about body inflammation levels from excess fat, and instead hang onto the mind-set that "the medicine" will "take care of me" -- and they go for the "quick fix" involved in the belief that a one-time chemo/rads series and maybe daily pills will make it so they don't have to do the ongoing dieting and exercising.

I don't think it would be difficult for my sister to be weighed in at every visit, and given a graph of her progress or lack of it, with some kind of science-based estimate on the percentage of risk increase (or decrease) based on her height and weight.

I choose (somewhat unenthusiastically) to exercise and diet, knowing that it hasn't made me back into a person that is at all close to being Mrs. America.

A.A.

AlaskaAngel · 03-30-2012, 11:37 AM

http://www.cancernetwork.com/nurses/.../10165/2039497

The goal of optimum health includes taking personal responsibility for maintaining it, of course.

Sometimes they have to prove the obvious first. (People who are cancer-free have a higher likelihood for healthy living.....)

The next step ought to be to determine which patients in the study completed major treatment with chemotherapy and which ones did not, to see whether the treatment itself would tend to result in poorer health practices. (Go ahead, make your best guess.)

The next step would be to look at those with the least risk, to see if forgoing major treatment results in better health habits that then result in better outcomes, the same outcomes, or worse outcomes.

A.A.

CoolBreeze · 03-31-2012, 11:29 AM

I'm nagged about my weight every week, Amy. But, I'm skinny. They want me to gain. Herceptin apparently doesn't work well for me, although I still get it. My doctor says at my current weight (92) I have no reserves if I'm bed-ridden. My ideal weight is 100. I started Abraxane Wednesday and was able to eat some yesterday, so who knows? Maybe my body was missing chemo.

So yes, some are tracking weight only not for the reasons you think!

Debbie L. · 03-31-2012, 03:08 PM

Interesting thread, I don't know how I missed it before.

A few things that occurred to me as I read.

First, it's not so simple as fat/estrogen. We don't really know the whole story yet but it's probably at least as much elevated insulin levels in response to too many simple carbs (insulin resistance/type II diabetes).

And second, it's not enough just to say that providers should encourage weight loss, and provide evidence, etc. Sadly, that just doesn't seem to work at all, for most people. In addition, again sadly and frustratingly, diets just don't seem to work longterm for most people. "Rethinking Thin" by Gina Kolata (a health writer for the NYT) is one book that looks at the issue of weight control in our society of plenty. It's an easy and interesting (albeit discouraging) read.

I'm not sure if there ARE answers, but it seems to me instead of just keeping on with telling people they should lose weight (no matter HOW we say that), it's time to reroute all that effort into figuring out what might actually work in getting the result everyone wants (longterm weight control and/or loss).

And my gut preference would be that we find a way that each person has individual control over -- not surgery nor drugs. One way to start that process might be by trying to get society to demand healthier foods -- fewer processed "foods" and fewer simple carbs (which are usually the same thing). This will be a hard task, as the food industry makes most of its money from processed things that our ancestors would not even have recognized as food.

Like I said, no answers from me. But an awareness that this is a complex issue. Obesity, although important to cancer, is a much larger influence on other deadly diseases -- so finding ways to decrease its incidence would benefit us (the big "us", all of society) in so many ways.

Debbie Laxague

Jean · 04-05-2012, 05:33 PM

Debbie,
Well said and placed. In today's society the portions that are generally served are huge. Enough for two people.
The battle does not have to be a battle...I think often times the idea of dieting is a nightmare.

I found that just eating normal portions works. Pushing back the plate. It's not only what you eat but how much.
Growing up in a home where my Mother was a wonderful cook - she would prepare wholesome meals that were mostly fresh veggies and fish, lean meats. Fruit and nuts were our desert. So it was easy for me when I went off to college and did not gain the freshman 15 pds. I was rather shocked at what students ate...pure junk food and it continues. When I would visit my son I was shocked with all the updated information and technology the poor food choices being made.

Also so much is pressed upon us to exercise. I say keep it simple - if you can't make it to a gym, so walk and walk some more. Park the car far away from where you are going and walk. It is amazing what you can fit into a normal day with out making the gym.

While it does become more challenging as we age
(I clearly see the difference these last few years) it's a matter of going the extra mile. My Aunt who 97 broke her hip during the holidays and my first thought was - this is very bad - she was up and walking in 3 days after surgery - the lady is going strong. Her mind is strong and talk about a survivor...that generation expected so much less and had less - but eat well. Keep meals simple and eat as fresh as possible.

Best Wishes,
Jean

MJo · 04-07-2012, 07:54 AM

I don't have answers. In fact, when I read this thread, I wanted to post "HELP!!" in case anyone does have answers. I'd be afraid of a skinny pill -- side effects.

I go to the gym three-four times a week for an hour, which does not help me control my weight because I eat more. I am very strong, though. Strong and 35 pounds over my top normal weight range.

Sigh....

AlaskaAngel · 04-07-2012, 09:16 AM

MJo,

To begin with I was a healthy food eater, not a junk food addict. I then got rid of every bit of anything that was not healthy food. No sugar, no flour, no corn products, etc.

Initially I did 30 minutes of jumping rope per day 7 days a week, and counted every calorie in everything (right down to the 20 calories in my daily fish oil pill). It took 6 years to lose 20 of the 25 pounds I gained during treatment. That worked.... but with the lower testosterone levels of postmenopause my ratio of muscle to fat was less muscle than prior to treatment, and in addition, my knee and ankle joints just couldn't take that on a continuing basis.

So I substituted some resistance/weight training but continued some aerobics. That helped, but the problem you are having with the constant hunger from the added exercise was intolerable for the long run. The weight all came back, even with the exercise and completely healthy food diet.

One especially disappointing learning for me was that although walking helps digestion and balance and is genuinely a good health practice and better than no exercise, it along with healthy food eating was completely inadequate in preventing slow weight gain. I think that is due to the lower testosterone level with aging. I was rapid-walking 3 miles 7 days a week using the highway markers, 1 hour a day. Using that hour of lost precious time every day for exercise, staying hungry, and continuing to lose ground by slowly continuing to gain weight was depressing.

The only thing that I have done in addition to healthy food diet and daily hour of combination exercising is the addition of 500 mg per day of metformin. The endocrinologist I saw tested me and I have no diabetes. I have no other chronic diseases. The metformin has helped. I know that the clinical trials they are doing that use the metformin to lessen recurrence are using a much higher dose per day.

AlaskaAngel

AlaskaAngel · 04-07-2012, 09:20 AM

P.S. I was hoping to add the notation for my metformin use to my profile, but I am not seeing the category for accessing my profile on the top of the screen to be able to do that. Am I blind, or is it missing entirely?

A.A.

Mtngrl · 04-07-2012, 11:31 AM

AA--

You're not blind. The "User CP" button is gone. But if you click on the "Private Messages" link you can get in that way.

Debbie said: "Like I said, no answers from me. But an awareness that this is a complex issue. Obesity, although important to cancer, is a much larger influence on other deadly diseases -- so finding ways to decrease its incidence would benefit us (the big "us", all of society) in so many ways."

Thank you, Debbie. So well said! I agree that it would be better if the solution were within people's control (even though a skinny pill would be so cool! Like Aladdin's Lamp!)

MJo · 04-08-2012, 09:56 AM

Thank you AA -- "the constant hunger from the added exercise" That validates my experience. I have only recently begun consistently exercising again. I expected too much -- like maybe it would be the answer to my lifetime struggle with food, which I think is addictive behavior in my case. I still have hope.

rhondalea · 04-08-2012, 10:30 AM

I read this the other day:

http://www.oncologystat.com/news/ASC...tients_US.html

A login is required to read the entire article (you can read the synopsis without a login), but signup is fast and easy.

It seems that those who are overweight are being shortchanged. Although excess weight may have its own impact on breast cancer, the fact that oncologists are undermedicating some of us may be skewing those statistics by quite a lot.

As for me, I'm trying out the intermittent low carb diet, and so far, I really enjoy it.

I started my breast cancer adventure hovering around 139-141 pounds, and two weeks ago, I hit 157. After a week doing the intermittent low carb plan (modified to one day low carb, followed by two days of normal eating), I'm at 154.2. (Yes, I know it's water, but almost 3 pounds right off the bat is soooooo motivating.)

Not being a dieter in the past (much less a low-carb dieter), I was surprised to find that my appetite is not overly active on low carb days or even the day following. This means that I've cut calories overall, as well as carbs.

Being the cautious sort, I meticulously planned my first day as if every little carb of the 50 carbs permitted were a precious jewel. Turns out, I came in at 35 carbs the first round and 37 the second without even trying. (And that doesn't even include a subtraction for fiber in my vegetables or sugar alcohol in my gum.)

My real problem is rebuilding muscle mass--my skeletal muscle percentage was 33%, but I'm now down to 29%. Every day, I tell myself to get down on the floor and plank, and every day, I just...don't.

Even if I do lose weight, I'm well on my way to becoming an amorphous blob.

Firework · 04-08-2012, 06:38 PM

I want to find the right combination that triggers my stubborn weight to drop a few pounds and I don't mean water.....I mean fat bUrned into muscles ...........that day will come if I c keep up this or that routine!
Pitch in some ideas!!! Love to have the
Lorraine

pilgrim37 · 04-12-2012, 04:34 PM

This thread is hitting me right where I live. After treatment I went on arimidex and have been on for about 2 years. In that time, my blood pressure and my weight went up despite eating healthily and walking. I went on a beta blocker for the blood pressure only to find I gained scary amounts of weight -- 20 pounds in a couple of months without changing my eating -- and also depression for the first time in my life. So I went off it and am now trying to drop the weight -- it's VERY tough. I think that arimidex may have fueled the blood pressure and the combo of arimidex and the beta blocker put on a lot of weight. I now need to lose 40-50 pounds. I won't go off arimidex but I wish I could figure out the "magic diet" that would help with the weight! I'm living on fruit, salads, quinoa, a little chicken and fish, legumes, and green juice! In the old days, I'd have been dropping weight at least 2 pounds a week, but now -- nada. Oh well, just glad to be alive. The extra weight makes me nervous though with studies like these...

diagnosed Sept 2009 with stage 3 her2+
treated at Dana Farber
3 months taxol/herceptin
bilateral mastectomy w/ node dissection Jan 2010
3 months A/C chemo
5 weeks radiation
herceptin till December 2010
now on arimidex and synthroid

AlaskaAngel · 04-15-2012, 04:46 PM

Thanks, MTN girl - I added metformin to my signature.

I think those of us who are 50 or older are just glad to get thru treatment when it is over, and still believe we can do what we always did before to shed the weight, but... no can do. Nobody explains how greatly our metabolism has slowed down, or even seems to "get it" that it actually does.

It is so important to introduce our medical providers to thinking about including a metabolic specialist in the discussions about us at the time of diagnosis, so that the planning doesn't end with completion of toxic therapies.

Eating is a "background", daily part of life and when conscientious diet and exercise don't do the trick after we have gone through a long period of treatment, we are stuck in a loop of slow weight gain.

Even harder is the whole picture for those like my older sister, who was quite overweight to begin with. I figure if it is hard for me (when I was able to maintain my weight clear up to age 51 and how hard it has become for me after treatment), I can see why it seems to hopelessly absurd to her to seriously try to address it.

The small daily metformin has stopped the weight gain for me as long as I do continue the daily diet and exercise.

Mtngrl · 04-16-2012, 04:38 AM

I am turning 58 in a couple of weeks. In early 2003 I experienced a sudden and devastating personal loss, and I simply lost my appetite. I dropped a lot of weight very quickly, without any effort. But when my broken heart began to heal and my appetite came back I just could not stop eating, and it was sugar and fat that I craved. Inadvertently, I became living proof that crash diets make you fat.

I have regained the lost muscle and improved my body composition, but for the last 5 years or so I have carried about 25 pounds more than I would like. Cancer treatment upped that to 40 pounds too many.

I am now back to what I weighed at diagnosis. I, too, think Arimidex may be complicating my efforts to shed excess fat.

I decided not to obsess about it. If I eat good food, avoid junk, and keep moving (including doing weight-bearing exercises to maintain muscle and bone) then I feel like I'm doing OK. I don't always hit those goals--the yoga DVDs and dumbbells are gathering dust right now--but I try to keep everything in perspective. I seem to be pretty healthy for someone with advanced cancer.

Although I actually weighed less after rebounding from the "crash diet," I appear to have less abdominal fat now. I won't pretend I have a flat stomach, but there's less bulging than there was.

Stress can increase cortisol, which can cause the body to store more fat, especially abdominal fat. So it seems that getting stressed about my weight might just create a vicious circle. . . .