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Improving Survival For Obese Breast Cancer Patients

Studying the effect of obesity on breast cancer recurrence and surivival are nutritionist Nora DiLaura, Dr. William Hryniuk and Dr. Zora Djuric.

Obesity appears to be associated with decreased survival time and increased recurrence rates in breast cancer patients. The question Drs. William Hryniuk and Zora Djuric are asking is this: Does weight loss have a positive effect on cancer survival and recurrence or are there underlying factors associated with obesity that won’t go away, even after weight loss?

Dr. Djuric, who has spent many years evaluating dietary factors and breast cancer risk, has been awarded a National Institutes of Health grant with Dr. Hryniuk to study weight loss strategies for obese breast cancer survivors. She has enrolled 48 people in a randomized trial testing various weight loss strategies. The most effective strategy was that combining individualized counseling with the popular Weight Watchers regimen.

Nutritionist Nora DiLaura devised the very intensive individualized counseling, most of which was done by phone to make it more convenient for the women participating in the trial. Next, researchers will analyze the blood samples collected in collaboration with Dr. Catherine Jen from the WSU nutrition department to look at cancer risk markers including oxidative DNA damage, insulin, insulin-like growth factor 1 (IGF-1), IGF-binding protein 3, leptin, glucose, lipids and triglyceride levels, all of which are thought to be affected favorably by weight loss.

The initial pilot study will follow the patients for 24 months. “We started this work almost two years ago, and are pleased that our subjects in the combined strategy lost an average of 10 percent of their initial body weight by six months. Most women also seem to be keeping the weight off, which is the most important part of the intervention program. We expect this weight loss will show a measurable effect, especially in reducing their insulin and leptin levels,” Dr. Djuric said. Insulin and insulin-like growth factor- 1 have been shown to stimulate proliferation of tumor cells. This offers just one explanation of why obesity is a risk factor for cancer.

“African American women have higher rates of breast cancer recurrence and shorter survival after a breast cancer diagnosis, and only part of this can be explained by being diagnosed with breast cancer at later stages in the disease process,” Dr. Djuric said. Drs. Hryniuk and Eun Young Song have also recently found that the drug tamoxifen, which is commonly taken by breast cancer patients for preventing recurrences, is less effective in women with diabetes. Since both obesity and diabetes are more prevalent in African Americans than Caucasians, finding weight loss methods that work for African-American breast cancer survivors is important. Drs. Djuric and Hryniuk have recently submitted such a proposal to the National Institutes of Health to test new weight loss strategies especially for African-American breast cancer survivors.

“Although losing weight can be difficult, it might increase the odds for improved outcomes after treatment for breast cancer,” Dr. Djuric said.

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