Journal of Clinical Oncology, Vol 11, 1418-1429, Copyright © 1993 by American Society of Clinical Oncology
Why women gain weight with adjuvant chemotherapy for breast cancer
W Demark-Wahnefried, EP Winer and BK Rimer
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC 27710.
PURPOSE: Among breast cancer patients receiving adjuvant chemotherapy,
weight gain is a common side effect that may decrease quality of life and
potentially threaten survival. Weight gain during treatment is a problem
that is clinically well appreciated, and one that has been studied by a
number of investigators. DESIGN: A literature review was conducted to
address each of the following issues: (1) the prevalence and magnitude of
weight gain in women receiving adjuvant chemotherapy for early-stage breast
cancer, (2) factors that might affect the amount of weight gained, (3)
adverse consequences of weight gain, (4) mechanisms potentially responsible
for weight gain, and (5) current dietary intervention programs directed
toward women receiving adjuvant chemotherapy. RESULTS: Weight gain is
associated with a number of adverse effects in breast cancer patients
receiving adjuvant chemotherapy. Weight gains are exaggerated in
premenopausal women and women receiving multiagent regimens. Little
research has been conducted to investigate the underlying mechanisms that
contribute to weight gain in this population. CONCLUSION: Interventions to
prevent weight gain during adjuvant chemotherapy are underway; however,
little research has been conducted to investigate the underlying mechanisms
of energy imbalance. Although changes in resting metabolic rate,
thermogenesis, physical activity, and dietary intake are all plausible, no
firm data exist to support any of these mechanisms. There is a need for
research that explores the relative contribution of each of these factors
to energy imbalance, so that optimally effective interventions can be
created and implemented to combat this problem.
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