June 1 marks a day of celebration for cancer survivors. National Cancer Survivors Day not only allows us to recognize and honor the 14 million cancer survivors in the United States, but it also gives us an opportunity to reflect on the many challenges that lie ahead for cancer survivors and their family members. Although not unique to cancer survivors, obesity is one of the leading challenges that can have tremendous impact on cancer survivors’ quality of life and remains one of the prominent difficulties faced by our society.
Over the last two decades, the United States has experienced an obesity epidemic. Today, nearly two thirds of American adults are overweight or obese. Obesity is an independent risk factor for many gynecologic malignancies, most prominently, endometrial or uterine cancer. Fortunately, the majority of women with uterine cancer are diagnosed at early stage and most will be cured of their disease. A recent survey revealed that more than half of gynecologic cancer survivors did not understand the implications of their obesity on the etiology or outcomes of their cancer. This knowledge gap presents a unique opportunity to utilize National Cancer Survivors Day to educate cancer survivors about the detrimental effects of obesity and empower them to achieve meaningful changes in their health.
Though providers are aware of obesity’s negative impact on health, time and social constraints make it difficult to confront these issues with their patients. The Society of Gynecologic Oncology (SGO) has launched an initiative to facilitate gynecologic oncology care professionals’ directed discussion of obesity with their patients. One goal is to take advantage of the shock of a cancer diagnosis as a captive, teachable moment, a call to arms or a time when a patient may be willing to face and battle her weight with a fervor and determination she did not have previously. The SGO has developed patient materials, discussion aids, and an information toolkit for both practicing physicians and patients to deal with this very difficult issue. (www.sgo.org/obesity)
The Institute of Medicine recommends that every cancer patient have a survivorship plan. This plan should include information about ways to prevent other diseases and to keep healthy overall. Weight loss can decrease the risk diabetes, heart disease and cancer recurrence. For the cancer survivor, our patient information materials provide information about diet, exercise, surgical intervention and discuss potential impact on quality of life and survivorship to aid in the transition to living a healthier lifestyle. In addition to resources to help one facilitate a lifestyle change, there now several clinical trials that cancer survivors may have the opportunity to participate in to assess the impact of exercise on health. Our website is a resource for patients to identify these trials, but they also may be located at www.clinicaltrials.gov.
June 1 is not only a day to celebrate and rejoice, but also a chance for cancer survivors to recommit to a healthy lifestyle.
All the best,
Richard R. Barakat, MD