Check Up: Chemotherapy and weight gain

Posted: January 30, 2012

While people commonly think that cancer patients lose weight because chemo makes them so sick, many patients actually have the opposite problem.

It is true that some people with end-stage cancer get very thin, but, earlier in the course of treatment, many may find themselves surprised by unwanted flab.

Cancer Support Community of Philadelphia has taken on the issue in several programs this winter. One late Monday afternoon will focus on fitness and weight management for cancer survivors.

Obesity is associated with increased risk of developing several cancers, including esophageal, breast, pancreatic, colon, and kidney. Studies have found increased risk for recurrence of prostate and breast cancer in patients who gained weight.

Katrina Claghorn, a registered dietitian at Penn's Abramson Cancer Center who spoke to survivors at the support community last week about losing the extra weight, said weight gain is a particular problem for breast-cancer patients but is often also an issue with gynecologic, prostate, and testicular cancers.

Weight gain always comes up at classes Penn gives for breast-cancer survivors. "We have to devote half the class to weight management because it's such an issue," Claghorn said.

Medical issues aside, gaining weight makes patients feel bad. "They've gone through treatment. They've lost their hair. They have no energy. They're feeling miserable, and then they gain weight," she said.

It's still not clear why, but there seem to be a "tsunami of factors," Claghorn said. It could be related to the chemo drugs themselves or hormonal changes. Some women eat soothing carbs to settle their stomachs. They feel less energetic so they exercise less, and muscle turns to fat.

Losing the weight, typically an extra 10 pounds or so, can be very difficult. Claghorn said a low-fat diet with no more than 25 percent of calories from fat can help patients lose weight and live longer. Exercise also helps.

Patients used to think they could load up before starting chemo because they'd lose weight later. Word has gotten out that that's not true. "Doctors have gotten much better at warning women about the potential for weight gain," Claghorn said.

- Stacey Burling

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