Breast Cancer Survivors Gain Weight at a Higher Rate than Their Cancer-Free Peers

“Breast cancer survivors with a family history of the disease, including those who carry BRCA1 and BRCA2 gene mutations, gained more weight over the course of four years than cancer-free women—especially if they were treated with chemotherapy, according to a prospective study by Johns Hopkins Kimmel Cancer Center researchers.

“Data from earlier studies suggest that breast cancer survivors who gain weight may have a higher risk of having their cancer return, the researchers say, noting that gains of 11 pounds or more are also associated with a higher risk of developing cardiovascular disease.

“For the study, the researchers reviewed a baseline questionnaire and a follow-up one completed four years later by 303 breast cancer survivors and 307 cancer-free women enrolled in an ongoing and long-term study at the Kimmel Cancer Center of women with a family history of breast or ovarian cancer. Study participants completed a baseline and at least one follow-up questionnaire between 2005 and 2013, and one-quarter of the subjects were premenopausal.”

New Data on Fatigue from ROMANA 1, a Pivotal Phase III Study of Anamorelin in Advanced NSCLC Patients with Cachexia Presented at 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology

The gist: A new drug called anamorelin might help people with advanced non-small cell lung cancer (NSCLC) who are dealing with cachexia. Cachexia is loss of weight and muscle mass, and weakness. Anamorelin was tested in a clinical trial with volunteer patients who had advanced NSCLC and were suffering from cachexia. The drug appeared to increase the patients’ “lean body mass and body weight, reduce fatigue and improve health-related quality of life.”

“In ROMANA 1, a pivotal Phase III study, anamorelin was shown to increase lean body mass and body weight, reduce fatigue and improve health-related quality of life in patients with advanced NSCLC cachexia.

“Helsinn Group, the Company focused on building quality cancer care, announces that anamorelin, its investigational novel once-daily ghrelin receptor agonist for the treatment of cancer anorexia-cachexia syndrome (CACS), delivered significant improvements in lean body mass [LBM; one of two primary endpoints] in ROMANA 1, a pivotal 12-week Phase III study in non-small cell lung cancer (NSCLC) patients.

“The results underscore the potential for treatment with anamorelin to support the care of patients with CACS, a poorly-understood and debilitating condition that affects a majority of advanced cancer patients but for which existing treatment approaches are limited.

“In the ROMANA 1 trial, over the course of the study, patients treated with anamorelin demonstrated an increase in body weight along with improvements in patient symptoms and concerns, such as appetite, early satiety and fatigue.”

Clinicians More Pessimistic About Lung Cancer Patients

A recent study suggests that clinicians have more negative perceptions regarding their lung cancer patients compared to other patients with cancer. The study analyzed how health care providers rated over 3,000 patients with solid tumors. The clinicians rated lung cancer patients as having a poorer quality of life and a higher rate of weight difficulties than other cancer patients. These findings were independent of how advanced the cancer was, how much the patients were functionally impaired, and how patients themselves rated their outcomes. It is not yet clear whether these ratings reflect a realistic assessment of the difficulties in treating lung cancer or a perception bias.

High Body Weight Is Protective Early On in Lung Cancer, But Not Later

People with a higher body mass index (BMI)–that is, those who are heavy for their height–are at lower risk of lung cancer. However, the effect of BMI on those who do develop lung cancer is less understood. A recent study found that among patients with advanced non-small cell lung cancer (NSCLC), those who were obese had higher survival rates early in the study than normal-weight or merely overweight patients. However, after 16 months on the study, the survival rates of obese patients dropped below those of other patients. Over time, the risk of death from other causes that obesity poses appears to outweigh the protective effect of high body weight against death from lung cancer.

Online Dietary Recommendations for Cancer Patients Are Inconsistent

Dietary guidelines for cancer patients on the websites of even high-quality cancer treatment centers are inconsistent and contradictory, a recent survey showed. Of 21 institutions surveyed, only a minority provide their own online nutritional recommendations; the rest either link to external websites or provide no guidance at all. Half of the websites recommend a low-fat, high-carbohydrate diet, while the other half recommend equal amounts of fat and carbohydrates. Several specific foods are recommended on some websites, but discouraged on others. Many of the guidelines are aimed at avoiding weight loss; however, weight loss is a significant risk only in some cancer types and obesity is associated with poor outcomes in other cancer types. The survey underlines the need for studies leading to consistent, cancer-type-specific nutritional guidelines for cancer patients.

Research paper: