In women with breast cancer, overweight and obesity increase the risk of the disease returning. This is a fact. And although there is still no evidence of the effectiveness of slimming in lowering this risk, there are many researches that try to find slimming programs that women can carry on for a long time.
One of these is conducted by Jennifer A. Ligibel, at the Dana-Farber Cancer Institute and concerns a combined intervention of nutrition education and support telephone calls, easy to follow even in areas farthest from large treatment centres, which due to its originality and extension was chosen among the most important studies of the annual congress of theAmerican Society of Clinical Oncology (Asco)running in Chicago from June 2 to 6.
A few weeks ago Ligibel was in Milan to take part in “Me[e]t Immune Conference”, a conference organized by the National Cancer Institute to take stock of the effects of metabolism modulation on tumors. On that occasion he spoke about his study and the expected positive results.
“Attention to a healthy lifestyle that allows you to counteract metabolic inflammation is the subject of great attention in the scientific world. The rationale is certainly strong, but so far the evidence is much less so. In fact, despite the numerous publications, the complexity ‘of the cancer universe’ and the numbers of studies published up to now allow recommendations of principle, but do not give definitive indications”, he comments Filippo De Braud, director of the INT Oncology and Oncohematology Department and conference director. Ligibel’s study helps provide guidance on tools to use to help patients lose weight.
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The ultimate goal of the study is to evaluate whether weight loss could lead to a reduction in recurrence and mortality in overweight or obese patients with HER2 negative stage II-III breast cancer.
The study involved more than 3,000 women (representatives of different ethnic groups, social classes and ages) who had completed chemo or radiotherapy and randomly divided them to receive an education program on correct lifestyle with indication of a diet with or without periodic telephone coaching (control group).
After one year, the group of women who received the phone calls reported a significantly greater decrease in weight than the control group, especially postmenopausal patients. “Our study demonstrates that weight reduction interventions can be effective in different patient populations with breast cancer. The next step will be to see if this weight loss also translates into a decrease in recurrences and mortality. If our study achieves these goals, it will have very important implications, demonstrating that weight loss should be part of the therapy for women with breast cancer,” said Ligibel.
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The American researchers will also evaluate the level of physical activity and the nature of the changes that have taken place in the diet to better understand what the impact of the various factors may be on the health of the patients. This will also be accompanied by a study of some biomarkers relating to metabolism, inflammation and immunity, in order to shed light on the mechanisms through which obesity influences oncological disease.
“Diet and exercise are certainly a combination that leads us to live in a healthier way and to reduce the risk of pathologies such as diabetes, hypertension, heart disease, and metabolic inflammation. However, when it comes to tumors we are faced with many different pathologies both for etiology than for biological and metabolic characteristics, and the evidence must be as specific as possible”, underlines De Braud.
Another recent one study published in JAMA Network Opengoes in the same direction. In this case, 1,340 women at high risk of developing a recurrence of breast cancer were followed. The results show that those of them who made the positive lifestyle changes recommended by theAmerican Cancer Society and fromAmerican Institute of Cancer Research she was 37% less likely to get sick again and 58% less likely to die than the others.
The recommendations concern an increase in physical activity and the consumption of fruit and vegetables, the control of the body mass index, the reduction of the consumption of red and processed meat, sugary drinks and alcohol, and the cessation of smoking. However, this study cannot prove that it was precisely the lifestyle changes that improved the survival data. And that’s why there is a need for targeted studies, designed ad hoc.
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Specific diet or calorie restriction?
Another aspect that scientific research in this field will have to ascertain is whether, when it comes to dietary intervention, what counts is the type of diet (and therefore the choice of certain foods over others) or simply the reduction in calories.
“And while the composition of the diet and the reduction of calories consumed are the basis of ‘healthy’ lifestyles, severe calorie restriction for limited periods and in conjunction with medical treatment of tumors is being studied at the INT with very promising. This is to be considered as a drug and as such cannot be improvised, but must be studied methodically and with great seriousness”, concludes De Braud.