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Oncologist. 2010;15(6):556-65. doi: 10.1634/theoncologist.2009-0285. Epub 2010 May 27.

Obesity and cancer.

Author information

  • 1Department of Surgery, Washington University School of Medicine, and Siteman Cancer Center, Barnes Jewish Hospital, 660 S Euclid Avenue, St. Louis, Missouri 63110, USA. wolink@wustl.edu

Abstract

Weight, weight gain, and obesity account for approximately 20% of all cancer cases. Evidence on the relation of each to cancer is summarized, including esophageal, thyroid, colon, renal, liver, melanoma, multiple myeloma, rectum, gallbladder, leukemia, lymphoma, and prostate in men; and postmenopausal breast and endometrium in women. Different mechanisms drive etiologic pathways for these cancers. Weight loss, particularly among postmenopausal women, reduces risk for breast cancer. Among cancer patients, data are less robust, but we note a long history of poor outcomes after breast cancer among obese women. While evidence on obesity and outcomes for other cancers is mixed, growing evidence points to benefits of physical activity for breast and colon cancers. Dosing of chemotherapy and radiation therapy among obese patients is discussed and the impact on therapy-related toxicity is noted. Guidelines for counseling patients for weight loss and increased physical activity are presented and supported by strong evidence that increased physical activity leads to improved quality of life among cancer survivors. The "Five A's" model guides clinicians through a counseling session: assess, advise, agree, assist, arrange. The burden of obesity on society continues to increase and warrants closer attention by clinicians for both cancer prevention and improved outcomes after diagnosis.

PMID:
20507889
[PubMed - indexed for MEDLINE]
PMCID:
PMC3227989
Free PMC Article

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