By Eleanore OsborneCorrespondent
You have cancer."
Hearing those words once is devastating. Is there anything you can do to prevent hearing them a second or third time?
Many studies have focused on factors affecting cancer recurrence, and now a national clinical trial is underway to determine whether losing weight changes the risk of cancer recurrence in women who have been diagnosed with early breast cancer. Florida Hospital Memorial Medical Center has opened a National Cancer Institute clinical trial to address this question.
The Breast Cancer Weight Loss study (BWEL) will enroll more than 3,000 patients with breast cancer in the United States and Canada, said Lindsay Cashio, the hospitals assistant director of communications. The results of this study will help researchers understand if losing weight after breast cancer diagnosis helps to decrease the risk of breast cancer recurrence. It is very exciting, as it is the first large, national, randomized trial examining this issue.
The trial has two parts. One for those on the trial itself, the other for those in a health education control group, about half in each. Admission to the clinic trial is limited to stage II and stage III breast cancer patients who are within one year of their initial diagnosis, older than 18, with a BMI of 27 or greater and other criteria.
For those women who are not eligible for the trial, a Florida Hospital Memorial Medical Center Cancer Institute registered dietitian will run a six-week series of classes called Weight Loss for Breast Cancer Survivors.
Judy King, 75, Ormond Beach, is attending the classes, which she heard about while volunteering at the cancer center. In 2002, King had a mastectomy on one breast, and in 2011, a recurrence on the same side, affecting her lymph nodes.
After five years, you think you are home clear, she said, but studies show that recurrence can happen at any time. Kings recurrence was discovered by her masseuse, who told her: I dont like the feel of this. You need to have this checked.
Dr. Eric Harris said weight gain after breast cancer treatment is common. Harris, partnering with the hospital and the trial, is a hematologist/oncologist, said stress, anxiety and supportive care drugs, such as steroids and hormonal anti-estrogen treatments, can cause increased appetite and weight gain. Patients can feel pretty beat-up following treatment.
In secondary prevention, doctors address diet and exercise, estrogen, smoking and keys to a healthy lifestyle.
For the first time, with this trial, we can count the data, Harris said. This is an exciting opportunity for patients of stage 2 and 3. It adds more data to our collective resources, to see if weight changes outcomes basically, we are chiseling away at secondary prevention.
Weight and fat cells are integral to the study, since fat cells make estrogen and estrogen can make hormone-receptor-positive breast cancers develop and grow.
Nutrition classes
In 2002, patient Judy King had attended nutrition classes and decided to lose 20 pounds. After her 2011 treatment, she started taking Aromasin, a pill that blocks estrogen from getting into her cells, and complained to her doctor that she couldnt keep her weight off because of it. He called it the fat pill, but said it was helping to keep her alive. Thats when King learned about the nutrition classes. I knew a lot from before, but thought, maybe I could pick up some more hints on what to do from the dietician. She has been really helpful.
That would be Jennifer Robinson, registered dietitian, who is leading the six-week classes for those who arent eligible for the BWEL trial. The Weight Loss for Breast Cancer Survivors class series are free and open to all breast cancer survivors in the community. All classes are at 1 p.m. at Florida Hospital Memorial Medical Centers Cancer Institute conference room. Classes so far have covered general nutrition, supermarket shopping, and dining out. Remaining classes this session are:
Classes will start over at a time to be announced, and will possibly include locations in West Volusia or Flagler County.
The classes offer motivation and camaraderie, said Robinson, an opportunity to be in a room with women who have been trying to practice healthful eating. The BWAL is amazing, but we dont want those women to feel let down. Okay, you didnt qualify for the study, but we are offing this as an option.
The sessions are free and open to all breast cancer survivors in the community, regardless of when their diagnosis was or whether they had treatment at Florida Hospital.
About Recurrence
Dr. Jennifer Ligibel, a breast oncologist in the Susan F. Smith Center for Womens Cancers at Dana-Farber Cancer Institute in Boston, said this by phone: We are trying to study the effects of different strategies to lower the risk of breast cancer recurring, and a way for women to help themselves and hopefully have fewer problems from their breast cancer. Ligibel is the lead investigator of the BWEL trial.
This is even more important to those who have undergone breast cancer treatment because it is common for people to gain weight during and after breast cancer treatment, especially if theyre treated with chemotherapy, steroids, and/or hormonal therapy. If breast cancer treatment puts you into menopause, youre more likely to gain weight too.
Judy King has these tips: Eat a variety of vegetables. Watch out for trans-fats. Control portion size. Drink enough water. When you eat out, have a plan. King, a science teacher in New Hampshire before retirement, added: Walking is so important. Youve got to get up and move your body. The enemy is the front door.
On the brighter side: a recurrence of breast cancer is not hopeless. Many treatment options are available and new medicines are being tested every day.
Nutrition and physical activity, said Robinson, are definitely things women can do for themselves.
To learn more about the trial or classes, call Sandy Allten, Florida Hospital Memorial Medical Center Cancer Institute, clinical research nurse, at 386-231-4023.
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Clinical trial: Florida Hospital explores weight gain and breast cancer recurrence - Daytona Beach News-Journal
