Clinical Management of Obese Patients With Cancer
Thursday, July 25, 2013
Metastasizing Cancer Cell
Obesity is a risk factor for many cancers. But even if this were not the case, the increase in the number of people living with obesity means that more obese people will be diagnosed with cancer than ever before.
The many complex issues facing oncologists in managing their obese cancer patients are nicely summarized and reviewed in a paper by Wenjing Tao and Jesper Lagergren from the Karolinska Institute, Stockholm, Sweden, in a paper published in Nature Reviews Clinical Oncology.
As the authors point out, not only does a large body of epidemiological evidence link obesity to increased cancer incidence, but there is also evidence suggesting poorer survival in obese patients with cancer.
There are also a number of important challenges related to diagnosis including reduced participation of obese individuals in cancer screening programs, lower tumour-marker expression and problems with medical imaging among obese individuals.
Excess body weight also alters pharmacokinetics of chemotherapy and hormone therapy and precision of radiotherapy might be adversely affected by greater skin motility and increased motion of internal organs.
Obese patients can also face higher risks of complications with surgery and recovery times may be affected.
Finally, the authors discuss the importance of sarcopenic obesity and the problem of excess weight gain associated with cancer survival, both of which can affect long-term outcomes.
But, as the authors conclude,
“Although the number of obese patients with cancer is rapidly growing, there is a lack of evidence-based clinical guidelines specifically addressing diagnosis and treatment for these patients.”
@DrSharma
Kananaskis, AB
Tao W, & Lagergren J (2013). Clinical management of obese patients with cancer. Nature reviews. Clinical oncology PMID: 23856746
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Sunday, August 25, 2013
Are you having trouble controlling the way you eat? Many of us with this problem have found help in Food Addicts in Recovery Anonymous (FA). FA is a program based on the Twelve Steps of Alcoholics Anonymous. The program offers help and recovery to those whose connection with food can be understood as a form of addiction. There are no dues or fees and the meetings include no weigh-ins. Membership is international and includes men and women, adolescents, and the elderly. All are welcome.
People who find help in FA vary greatly. Some of us have been diagnosed as morbidly obese while others are undereaters. Among us are those who were severely bulimic, who have harmed themselves with compulsive exercise, or whose quality of life was impaired by constant obsession with food or weight. We tend to be people who, in the long-term, have failed at every solution we tried, including therapy, support groups, diets, fasting, exercise, and in-patient treatment programs.
Some of our members have been in continuous recovery (maintaining a stable, healthy weight and enjoying freedom from obsession with food, weight, bingeing, or bulimia) for over twenty-five years. Members with five to ten years of recovery are increasingly common.
FA has over 350 meetings throughout the United States in large and small cities such as Boston, San Francisco, Los Angeles, New York, Charlotte, Grand Rapids, Atlanta, Fort Lauderdale, Austin, and Washington, D.C. Internationally, FA currently has groups in England, Canada, Germany, New Zealand and Australia. If you would like more information about FA, please check out our website. If there aren’t any meetings in your area, you can contact the office, where someone will help you.