Oncologists are increasingly being called on to address obesity in cancer patients as the rates of obesity are increasing and more cancer patients are becoming cancer survivors, according to a position statement on obesity and cancer from the American Society of Clinical Oncology.
Obesity appears to have negative downstream effects for cancer risk, recurrence, and mortality. As many as 84,000 cancer diagnoses each year are attributed to obesity, and overweight and obesity are implicated in 15%-20% of total cancer-related mortality,” wrote Dr. Jennifer A. Ligibel from the Dana-Farber Cancer Institute, Boston, and her colleagues in the statement, which calls for increased education, clinical guidance, research, and advocacy on the issue.
Dr. Jennifer A. Ligibel
Evidence suggests that obese individuals have a significantly worse prognosis than do nonobese patients. One meta-analysis found a 75% increase in mortality in premenopausal women who were obese at the time of breast cancer diagnosis, compared with normal-weight patients. Further, obesity can interfere with the delivery of cancer therapy and is associated with increases in the risk of second primary malignancies, according to the paper published Oct.1 in the Journal of Clinical Oncology.
Dr. Ligibel and her colleagues said many individuals initiate positive health behavior changes after a cancer diagnosis, and such a point can therefore serve as a “teachable moment” that may offer the chance to motivate individuals to implement lifestyle and behavioral changes.
The statement advised assessing patients’ weight by calculating BMI and referring patients to appropriate services such as oncology nutrition, rehabilitation medicine, and exercise physiology. Oncologists also are encouraged to lead by example and to share their personal experiences at attempts to lose weight and to increase physical activity. Participating in community events focused on physical activity and healthy living “can also reinforce the importance of health lifestyle behaviors as part of a a comprehensive cancer-control strategy,” the statement said.
ASCO also announced that it will host a summit to assemble groups needed to conduct lifestyle intervention research in cancer survivors and urged studies of lifestyle changes on outcomes in patients with early-stage cancers.
Additionally, ASCO has developed a toolkit to assist in addressing weight management, including strategies for improving nutrition and physical activity as well as insurance coverage for weight-management services.
The authors declared no conflicts of interest.