Why Managing Post-Diagnosis Weight Gain Is Critical in Breast Cancer Care

Sherry Shen, MD, discussed the multi-faceted challenges patients with breast cancer experience regarding weight gain during and after active treatment. From the immediate fluid retention and steroid use associated with chemotherapy to the long-term metabolic impacts of endocrine therapy and treatment-induced menopause, patients frequently see significant shifts in fat distribution and metabolic health. Shen highlighted why addressing a post-diagnosis weight gain of over 10% is critical, noting that cardiovascular disease, not breast cancer, is one of the leading causes of death for these patients in the long term.

Shen is an assistant attending physician at Memorial Sloan Kettering Cancer Center.

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Transcript:

We know that so many of our therapies for breast cancer can cause weight gain. Starting with chemotherapy, patients get a lot of fluids, they get steroids, they have altered diet, and they change their physical activity. That tends to be a short-term change over a couple months as people get chemotherapy, but then most of our patients go on to receive long-term endocrine therapy as well, which in and of itself can contribute to weight gain. In addition, a lot of our patients are perimenopausal, recently postmenopausal, going through that change. Going through menopause in and of itself with the steep drop in estrogen levels changes the way that the fat is distributed in the body and changes metabolic health as well. Whether patients are naturally going through menopause, or we’re even inducing menopause with some of our endocrine therapies, that is going to lead to long-term weight gain. We know that weight gain post diagnosis—so following a breast cancer diagnosis—is associated with worse outcomes long term. Particularly, post-diagnosis weight gain of over 10% of someone’s diagnosis body weight is associated with those worse outcomes. We also know that not just weight gain but cardiometabolic health is important, too. Right now, that for our [patients with] breast cancer, there is fortunately such a high cure rate that the number one cause of death after breast cancer diagnosis is cardiovascular disease, not breast cancer, and that’s all interrelated with weight. All of this is so important for our patients. It’s such an important issue that we need to, as oncologists, be cognizant about long term and continue to help our patients work on.