Reasons for Weight Gain After Breast Cancer Therapy - A Discussion

Introduction:

Weight gain is cumulatively caused by to increased intake of food, a surplus of energy, or decreased energy expenditure. More than half of the population affected with breast cancer has reported weight gain after mastectomy. According to the researchers, too much weight gain can limit the chances of recovery. Chemotherapy is particularly linked with weight gain, along with other therapies like steroid medications and hormonal therapy. Chemotherapy has been known to cause premature menopause and slow down the metabolism. However, women who have undergone surgery or radiation therapy have not reported significant weight gain.

What Might Cause Me to Gain Weight?

Weight gain usually starts after the first year of diagnosis, and grows rapidly after starting chemotherapy, steroid medications, and hormones. Weight gain can affect the metabolic changes in cells and interfere with ATP (adenosine triphosphate) production and mitochondrial function, which can result in adverse effects on the body. Physical inactivity is also a major cause of weight gain. Drug regimens containing Cyclophosphamide, Methotrexate, and Fluorouracil (CMF) have been shown to cause significant weight gain of up to eight to ten kilograms when combined with Prednisolone as an anticancer agent. Doxorubicin and Cyclophosphamide are some of the anthracycline-containing drugs causing significant weight gain in patients receiving chemotherapy within a period of two years.

1. Chemotherapy:

Chemotherapy can cause weight gain through the following modalities:

• It will cause edema in the body by holding on to excess fluid.

• Chemotherapy can cause fatigue and the affected individuals find it hard to exercise.

• Nausea is prevalent in individuals under chemotherapy which will trigger intense food cravings, thereby eating more food.

• Chemotherapy has also been shown to reduce metabolism, and hence weight gain.

• It also causes premature menopause in some women, and there will be a slower metabolism.

2. Hormonal Therapy:

Hormonal therapy is used to treat breast cancer and other cancers like prostate, uterine, and testicular types. Hormonal therapy can decrease certain hormonal levels, especially estrogen, progesterone, or testosterone. This will, in turn, lead to increased fat, and decreased muscle mass. Women who took Tamoxifen have reported significant amounts of weight gain. While women who received both hormonal therapy and chemotherapy have reported much higher weight gain.

3. Steroid Medication:

Steroid medications help reduce swelling and pain caused due to inflammation. They are also used to treat nausea. But steroids lead to weight gain as they can increase the appetite, stop muscle wasting, and increase fat tissue deposition.

4. Menopause:

In premenopausal women, the weight gain is more compared to postmenopausal women. Chemotherapy-induced amenorrhea (absent menstruation) is a significant risk factor in young women undergoing cancer therapy. According to a study about weight gain after a cancer diagnosis, conducted in January 2011 in Australia, 43 % of women were premenopausal and 12 % were perimenopausal when diagnosed.

In the end, to answer the frequently asked question, does cancer cause weight gain? Yes, it does, and a few more reasons are emphasized below.

1. According to a few research, not exercising may also contribute to weight gain. It is normal to experience worry, exhaustion, nausea, and pain during cancer treatment. That may cause your level of physical activity to decline.

2. Strong food cravings may also contribute to weight gain. During chemotherapy, some women experience cravings for carbohydrates and sweets. Consuming these meals in excess can result in weight gain.

Do Other Breast Cancer Medications Cause Weight Gain?

Hormone therapy is another possible cause. This therapy reduces testosterone levels in men and estrogen and progesterone levels in women. It also tends to increase body fat. At the same time, your body's ability to turn food into energy changes, and your muscle mass decreases.

Tamoxifen users often believe the medication is to blame for their weight gain. However, no solid research has yet to link this hormone to the benefits. Women who have had surgery alone or who have had surgery followed by radiation alone do not usually gain weight.

What Are the Risks of Gaining or Losing Pounds?

Weight gain is commonly seen in young women during or after cancer therapy. The chemo weight gain ranges from one to five kilograms. In the body composition, there has been an increase in fat mass and a decrease in lean body mass. Some women gain weight if they have lymphedema (swelling caused due to fluid build-up). However, cancer weight gain in females in many ways, causes distress, a negative body image, and low self-esteem. Additionally, weight in cancer patients can lead to weakness, worsen the prognosis, and increase the risk of developing diabetes, and heart disease, surgical outcomes will be poor, with reduced life quality, ultimately affecting the treatment progress. Hence, a weight acceptance program (intervening to prevent weight gain during therapy) is focused, and it has been proven to reduce the number of cardiovascular events and help women by reducing the risk factors precipitating morbid cardiovascular conditions and improving the quality of life.

Weight loss during breast cancer can be due to difficulty eating, nausea, vomiting, and anxiety, and also your energy levels may drop as a result of losing weight, and your recuperation may be hampered by inadequate nutrition. Also, cancer releases a few chemicals in the blood which reduces the ability to absorb nutrition from foods.

What Should I Eat During My Treatment?

Maintain a diet that is well-balanced and contains lean meat, poultry, fish, bread, dairy products, and fruits. Eating a diet reduced in total and saturated fat reduces the risk of heart disease and the recurrence of breast cancer.

Protein intake must be adequate. While undergoing treatment, this aids in the development and regeneration of muscles, skin, and hair. It might also help you work out better.

You can combat infections and cope with the negative effects of chemotherapy by eating a healthy diet. It speeds up the body's process of repairing healthy tissues.

Additionally, when undergoing chemotherapy, make sure to stay well-hydrated and safeguard your kidneys and bladder.

How to Prevent Weight Gain Caused by Breast Cancer Therapy?

Lifestyle and dietary modification, along with physical exercise backing, has led to improved quality of life and enhanced survival rate. There is limited evidence to prove the outcomes of weight loss in protocols carried out in breast cancer patients. Hence, a proper weight loss regimen still needs to be formulated.

Prevention of cancer weight gain in females is as important as breast cancer prognosis due to the side effects of obesity that can lessen the chances of survival. According to a study and a few researches the following have helped in weight management in patients undergoing cancer therapy. The American Cancer Society has suggested a few lifestyle changes to prevent breast cancer weight gainin women affected with breast cancer and undergoing treatment:

• Meeting with a dietitian before and during the therapy will help in managing weight through personalized diet plans and simple workouts.

• Cutting back on sugar and opting for low-calorie healthy food from natural sources.

• Drink more water. In patients with edema, limiting fluid intake is necessary to prevent weight gain.

• Limiting the intake can significantly affect weight gain.

• Simple exercise like walking or bicycling daily for 20 minutes can help in weight loss.

• Portion control should be followed in case of cravings.

• Restrict or limit using fats, refined flour, and processed foods.

• Try to include strengthening exercises as they can help regain muscle mass in patients with muscle wasting.

• Always prefer home cooking whenever feasible.

Conclusion:

Breast cancer is one of the most common cancers affecting women. Studies have reported significant breast cancer weight gain after undergoing therapies including chemotherapy, hormonal therapy, and steroid medications. Weight gain prevention during cancer therapy is quite challenging, and studies are still under process for identifying the correct amount of dosage that will provide a better prognosis and lesser side effects. Affected women find it difficult to exercise during therapy as they have fatigue and other chemotherapy-associated symptoms. Hence proper follow-ups with the physician and nutritionist will help the patient in a faster recovery path with fewer adverse effects.