Obesity and ovarian cancer survival

As I wrote earlier, excess weight seems to increase certain types of cancers in men and women.   Some of my patients with ovarian cancer asked if obesity affect ovarian cancer survival.   A Canadian study evaluated1423 women diagnosed with epithelial ovarian cancer in a large population-based study. 

Information on risk factors and characteristics was collected by telephone. Vital status was determined both by computerized record-linkage and by chart review. Statistical analysis was done for height, weight and body mass index in association with ovarian cancer-specific mortality.

The study concluded that  weight does not affect the survival of patients with ovarian cancer.   Please note that this study is about survival not risk factors.

However, another study by Protani who reviewed multiple studies concluded differently.  It showed obese patients with ovarian cancer seemed to have worse survival. My recommendation is still the same in regards to maintaining your healthy weight to reduce risks of certain cancers, heart disease and diabetes.

Reference:

Kotsopoulos J, et al.  Height, weight, BMI and ovarian cancer survival. Gynecol Oncol. 2012 Oct;127

-         Protani MM, Nagle CM, Webb PM.Obesity and ovarian cancer survival: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2012 Jul;5(7):901-10.

 

Santoso's way to lose weight

You plan to lose weight for wellness not cosmetic.  Your goal is only to lose 5-10% of weight in 6 months.  Celebrate a little success and have a supportive partner/friend to do it together. Approach weight loss slowly.

 Do not use this dietary guideline if you are diabetic without informing your diabetic doctor.  This guideline should be done under a physician’s supervision. 

Santoso’s recommendations

-          Set the wellness goal: what is your weight – 5-10% of weight loss in 6 months.

-          Minimize going to eat fast food or going out to eat. 

o   All fast foods have excess calories.  Eats there only as a treat once a month

-          Drink only water (may drink diet soda once a month as a treat)

o   Most soft drink/sport drink/ fruit juice has about 100 cal per serving. 

o   I minimize diet soda since it makes us crave for more high sweet drink/food

-          Maximal 1200 calories/day of all food and drink (everything you put in your mouth)

o   soups – preferably vegetable based soups.  Warm it up so you eat slower

o   packaged prepared food with calorie label (lean cuisine, etc)

o    Add proteins (1-2 glass of milk/ day).   1 glass of skim milk = 80 cal. 

o   Eat 3 meals with 2-3 fruits/milk snacks.  You cannot lose weight by being hungry

o   Avoid large meals or snack at night

-          Exercise 30 minutes/day

o   Put exercise in your daily routine (park your car far, take stairs instead of elevator, wash your car manually, etc)

-          Food diary

o   Write everything that you put in your mouth

o   Write date, time, what you eat and estimate calorie

o   Example of food diary

Date        time                         what I ate                                how many calorie

9-2-12      6pm             3 oz of baked chicken                         100

                                    1 cup of vegetables                             50

                                    1 baked potates                                   300

                                    1 apple                                                 100

How to estimate calorie

-          Lean meat (beef, chicken, pork with fat mostly removed): 100 cal/3 oz.  3 oz is about the size of a deck of cards

-          Carbohydrates (pasta, rice, etc): 200 cal/cup.  One cup is the size of your fist.

-          Fresh fruits: a medium serving (apple, orange, etc): 100 cal/serving.  Please note that medium serving is not large size orange.

-          Vegetables (broccoli, cauliflower, etc): 50 cal/cup. 

-          Condiments (oil, cheese sauce, dressings): 100 cal/table spoon.  One table spoon is about your thumb size.

-          Fat, sugars, snacks: lots of calorie.  Read the labels.

-          Use your food diary to estimate calorie.  Then go to internet to check your calorie estimation.  With practice, you will improve your accuracy

Excess weight and cancer

Weight, weight gain, and obesity are associated with about 20% of all cancer cases. These cancers includes esophageal, thyroid, colon, renal, liver, melanoma, multiple myeloma, rectum, gallbladder, leukemia, lymphoma, and prostate in men; and postmenopausal breast and endometrium in women. Interestingly, Bariatric (weight loss) surgery has been associated with a 60 percent reduction in cancer mortality over seven year follow-up.  Thus, we have more incentives to lose weight.   Easy said than done.   So I will try to write my suggested weight loss recommendation at next blog.

Reference:

-          Wolin KY, Carson K, Colditz GA.  Obesity and cancer. Oncologist. 2010;15(6):556

-          Adams TD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753