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Originally published Sunday, November 10, 2013 at 5:11 AM

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To reduce cancer risk, slim down, doctors say

Here’s another good reason to lose weight: Excess pounds not only raise the risks of getting breast cancer, but also increase the chances cancer will return.

The Baltimore Sun

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BALTIMORE — Mother and daughter Angela and Candi Watts were both diagnosed with breast cancer in 2011. After a two-year battle, they are both disease-free, but the war continues. The new enemy is their waistlines.

Scientists have discovered that excess weight not only raises the risks of getting cancer, but also increases the chances cancer will return. Now, as medical studies seek to determine how much weight loss is needed for a better prognosis — and whether the fat-cancer link can be disrupted in other ways — patients are being encouraged to slim down.

“We need to do this for our health, now more than ever,” said Angela Watts, 59, who is among the first survivors to benefit from a calorie-counting computer program provided by Johns Hopkins Hospital, where she was treated for Stage 2 breast cancer. She dropped 5 pounds her first week.

The connection between fat and breast cancer, strongest in those diagnosed with the disease after menopause, is especially troubling given that two-thirds of the national population is overweight. Breast cancer remains the most common type of cancer for women, with more than 200,000 diagnoses and almost 40,700 deaths reported in 2009, the most recent year for which government statistics are available.

Doctors and public-health officials have long been promoting lifestyle changes to stave off heart disease and diabetes, but they believe fewer people associate better diets and exercise with cancer prevention.

Cancer patients, meanwhile, face their own hurdles. They might have trouble dieting and exercising because treatment often makes them gain weight while experiencing fatigue and other side effects.

Given those challenges, researchers across the country are seeking the best ways to change behaviors among those with a diagnosis and those who could be headed down that path.

Dr. Lewis E. Foxhall, who works on cancer-prevention policy at the University of Texas MD Anderson Cancer Center in Houston, said doctors don’t know exactly how much weight loss improves a prognosis.

Scientists theorize that obese women have elevated levels of hormones — including insulin, which regulates blood sugar; estrogen, a female sex hormone; and leptin, which helps regulate appetite — that lead to complex biological changes, including inflammation in the body that can promote cancer growth.

Some researchers are looking for ways to disrupt this link.

Dr. Vered Stearns, co-director of Hopkins’ breast-cancer program, will join with other U.S. and Canadian researchers during the next year in studying weight reduction among breast-cancer survivors — including Angela Watts — and how much their long-term health improves. She will enroll as many as 200 overweight women who completed treatment for breast cancer no more than five years ago.

Stearns provided Watts with the computer program and is “hopeful that our busy women will be able to adhere to the intervention that is both personalized and minimizes in-person visits.”

Watts says the computer program is helping her. She’s been through surgery, chemotherapy and radiation for her breast cancer, and she knows that dropping more pounds can reduce the risk of the cancer recurring.

The computer counts calories from her meals and subtracts calories burned from exercising — warning her when she’s approaching her daily 1,500-calorie limit. Watts said she weighed as much as 212 pounds and has a goal weight of 150. Cancer and her 4-year-old grandson Zhione, Candi’s son, are motivating her, she said.

Watts said she had no symptoms but was diagnosed with breast cancer in May 2011 when she went for a checkup a month after her daughter was diagnosed at the age of 32. The Watts women have a genetic mutation that increased their chances of cancer.

They were treated together at Hopkins and are now focused on diet and exercise. Angela Watts said her daughter, now 34, “doesn’t have as far to go” in losing weight and isn’t participating in the study.

“I always knew I had a weight problem, and losing the weight was something I always wanted but didn’t know how to achieve,” she said. “Counting calories is working for me.”

Watts said she walks at least 30 minutes on a treadmill daily. That gets her “excited to start the day.”

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