Overweight and obese patients face worse side effects and survival odds than others with the same cancer.
There are nearly 14 million cancer survivors in the U.S., and for many cancers, studies indicate more than two-thirds of those diagnosed are overweight or obese.
Obesity correlates with some cancer types more than others. And the increased risk can be substantial.
Dr. Edward Fernandez is here to help you better understand how obesity can effect cancer survival rates.
How Obesity Influences Survival Rate of a Cancer Patient
From the Show: Lourdes Health Talk
Summary:
Air Date: 3/21/16
Duration: 10 Minutes
Transcription:
Melanie Cole(Host): Overweight and obese patients can face worse side effects and survival odds than others with the same cancer but at Lourdes Health System, we’re here to help those patients get better care, become healthier and live longer. My guest today is Dr. Edward Fernandez. He is a hematologist/oncologist at Lourdes Health System. Welcome to the show, Dr. Fernandez. Tell us a little bit about the relationship between being physically active or being obese and cancer.
Dr. Edward Fernandez (Guest): I think in the scope of when patients are being treated, physical activity is the least of their concern but it is an important aspect of their care in the short term and in the long term. I think in the short term, it improves mood and there is a general belief that if you keep moving and keep doing, you’re going to feel better. I think that is, overall, the short term benefit. I think in the long term it’s an important aspect of overall health and actually impacts on survival in the scope of helping people maintain weight. Studies have born that out – that people who are physically active and have an ideal body weight are definitely surviving longer than patients who are obese and sedentary.
Melanie: Do we know if there is any relationship between physical activity or being fit and cancer risk?
Dr. Fernandez: I think the issue is that all good habits have an overall benefit in preventing cancer and even when people are diagnosed with cancer. Exercise and a good diet clearly impact on tolerability of side effects and in the long term survivability.
Melanie: What do you tell patients when they say, “Okay, that’s the last thing I’m thinking of. I’m going through treatment. I’m sick. I don’t feel well.” How do you give them that encouragement and that motivation to try and take walks to do something that’s healthier for them?
Dr. Fernandez: Usually, it actually comes from the family. Sometimes, it actually is a point of some stress between the patient and the caregiver because it is very difficult for someone who is undergoing treatment to physically feel like exercising in any manner. I think the important aspect isn’t “Hey, you should go to the gym and work out for 30 minutes or 40 minutes.” It’s really incorporating normal activities and exercise into the things that you would normally do such as walking, doing your normal daily routine, in the scope of gardening, shopping, and things like that. I think that’s the most that someone can expectto really feel up to doing when they’re in the midst of active therapy. I don’t really push a strenuous exercise program in the midst of active treatment. That’s a little bit different after they’re done because it is a time of recovery that they should start at that point considering to do more and more physical activity then they would normally do during treatment.
Melanie: What about an obese patient, Dr. Fernandez? Is treatment more difficult for someone? Is that not the time to try and lose weight at the same time?
Dr. Fernandez: Yes, I think taking on too many challenges is overwhelming. The issue of obesity, I think, from my standpoint in the scope of being treated for whatever cancer is secondary. I think getting through that initial period of treatment and then, after recovery what things people can do to lower their risk of a recurrence. In the scope of what people sort of think about, they all think about supplements and things like that. One thing that they can easily control is exercise and their eating habits. Clearly, studies have borne out the science of why people who are overweight and don’t exercise have a worse outcome than people who are more physically fit or near their ideal body weight.
Melanie: What do you tell people about getting into an exercise routine even if it’s not a strenuous one? What do you tell them is enough to do to at least give them that little bit of an extra edge?
Dr. Fernandez: That’s a difficult call because everybody is different. There is not really a standard but I kind of tell people to try and incorporate exercise in their daily activities. Instead of parking close to the entrance, if they feel up to it, maybe park a little further or take the stairs--those kind of things. Get out and get a little bit of sun, get a little bit of activity, fresh air. Take a walk in the woods is always a nice activity to freshen up the mind and recover from stress and work.
Melanie: If somebody says to you, “Well, I have these limitations” or maybe they’ve recently had surgery, are there other things that you recommend that they do along with their treatment to help them get through it, whether it be yoga or meditation, or nutritional things to think about?
Dr. Fernandez: Yes, there is sort of an entire spectrum of complementary treatment and therapies that we try and recommend to patients when they are undergoing therapy. We have the Wellness Center at Lourdes that is a place where patients can get information regarding nutrition and exercise. They have therapeutic massage and yoga. I think those are all important aspects of somebody’s recovery and well-being. I think sometimes it’s difficult to overcome apprehensions about those types of things that are not considered mainstream but I think they are vital components of overall health and recovery.
Melanie: Do people ask you for nutritional advice during treatment? If they are going through chemotherapy, maybe they are nauseous a lot, or radiation. Do they ask you what they should be doing nutritionally to help them along?
Dr. Fernandez: They certainly do. Unfortunately, there isn’t a "one plan fits all". I think it’s dependent on what particular side effects they’re having that mandate what they should do in the scope of adjusting their diet. I think calorie intake is an important aspect of good health and a balanced diet. There really isn’t a specific diet in the sense of “Hey, you need to eat this amount of fruits and vegetables” or “Avoid red meat versus fish and things like that". I think it’s very difficult to make significant dietary changes in the midst of everything else that is going on. I think it is a basic, “Hey, you need to eat well and balance your diet with everything that you know is supposed to be good for you.” Try to avoid the typical processed snacks and fast food kind of things that are not going to be overall good for you in the short term or in the long term.
Melanie: In the last few minutes, Dr. Fernandez, give your best advice about people going through chemotherapy, radiation and treatment for various cancers and what you want them to know about remaining physically fit or getting a little bit more fit and exercising than they did before their treatments.
Dr. Fernandez: I think there are different groups. There is the group that has always been healthy and they tend to remain focused and do the best they can in the scope of maintaining a good diet and exercise while they’re undergoing therapy. There is the in between group that needs a little bit of encouragement and they often will follow advice. Then, there is the group that has never really exercised. I think it has to be internalized what your ultimate goals are in treatment and after treatment – how you’re going to adapt your dietary habits and your exercise into your daily routine in the hopes that it’s going to potentially give you a better survival and a better recovery and function after treatment. You can advise but I think until it is internalized by those individuals who are not used to exercising or eating well, it’s somewhat of an uphill battle sometimes to really stress the importance of weight control and exercise.
Melanie: Dr. Fernandez, why should listeners come to Lourdes Health System for their care?
Dr. Fernandez: I think we have a family approach to care. We take care of patients like they were our family. I always tell people that the recommendations I’m making are the recommendations I would give to anybody in my family. That’s important. I think the other is compassion. We stress the humanistic aspect of care which, in this world of science and advancement, I think often gets forgotten. I think we also tend to look at the whole person in the scope of not only the particular disease they are being treated for and the treatments they are getting but what other aspects are affecting their quality of life and how we can improve that, whether it be through the Wellness Center or just spending the time to talk things out.
Melanie: Thank you so much, Dr. Fernandez, for being with us today. It’s great information. You’re listening to Lourdes Health Talk and for more information you can go to LourdesNet.org. That’s LourdesNet.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole(Host): Overweight and obese patients can face worse side effects and survival odds than others with the same cancer but at Lourdes Health System, we’re here to help those patients get better care, become healthier and live longer. My guest today is Dr. Edward Fernandez. He is a hematologist/oncologist at Lourdes Health System. Welcome to the show, Dr. Fernandez. Tell us a little bit about the relationship between being physically active or being obese and cancer.
Dr. Edward Fernandez (Guest): I think in the scope of when patients are being treated, physical activity is the least of their concern but it is an important aspect of their care in the short term and in the long term. I think in the short term, it improves mood and there is a general belief that if you keep moving and keep doing, you’re going to feel better. I think that is, overall, the short term benefit. I think in the long term it’s an important aspect of overall health and actually impacts on survival in the scope of helping people maintain weight. Studies have born that out – that people who are physically active and have an ideal body weight are definitely surviving longer than patients who are obese and sedentary.
Melanie: Do we know if there is any relationship between physical activity or being fit and cancer risk?
Dr. Fernandez: I think the issue is that all good habits have an overall benefit in preventing cancer and even when people are diagnosed with cancer. Exercise and a good diet clearly impact on tolerability of side effects and in the long term survivability.
Melanie: What do you tell patients when they say, “Okay, that’s the last thing I’m thinking of. I’m going through treatment. I’m sick. I don’t feel well.” How do you give them that encouragement and that motivation to try and take walks to do something that’s healthier for them?
Dr. Fernandez: Usually, it actually comes from the family. Sometimes, it actually is a point of some stress between the patient and the caregiver because it is very difficult for someone who is undergoing treatment to physically feel like exercising in any manner. I think the important aspect isn’t “Hey, you should go to the gym and work out for 30 minutes or 40 minutes.” It’s really incorporating normal activities and exercise into the things that you would normally do such as walking, doing your normal daily routine, in the scope of gardening, shopping, and things like that. I think that’s the most that someone can expectto really feel up to doing when they’re in the midst of active therapy. I don’t really push a strenuous exercise program in the midst of active treatment. That’s a little bit different after they’re done because it is a time of recovery that they should start at that point considering to do more and more physical activity then they would normally do during treatment.
Melanie: What about an obese patient, Dr. Fernandez? Is treatment more difficult for someone? Is that not the time to try and lose weight at the same time?
Dr. Fernandez: Yes, I think taking on too many challenges is overwhelming. The issue of obesity, I think, from my standpoint in the scope of being treated for whatever cancer is secondary. I think getting through that initial period of treatment and then, after recovery what things people can do to lower their risk of a recurrence. In the scope of what people sort of think about, they all think about supplements and things like that. One thing that they can easily control is exercise and their eating habits. Clearly, studies have borne out the science of why people who are overweight and don’t exercise have a worse outcome than people who are more physically fit or near their ideal body weight.
Melanie: What do you tell people about getting into an exercise routine even if it’s not a strenuous one? What do you tell them is enough to do to at least give them that little bit of an extra edge?
Dr. Fernandez: That’s a difficult call because everybody is different. There is not really a standard but I kind of tell people to try and incorporate exercise in their daily activities. Instead of parking close to the entrance, if they feel up to it, maybe park a little further or take the stairs--those kind of things. Get out and get a little bit of sun, get a little bit of activity, fresh air. Take a walk in the woods is always a nice activity to freshen up the mind and recover from stress and work.
Melanie: If somebody says to you, “Well, I have these limitations” or maybe they’ve recently had surgery, are there other things that you recommend that they do along with their treatment to help them get through it, whether it be yoga or meditation, or nutritional things to think about?
Dr. Fernandez: Yes, there is sort of an entire spectrum of complementary treatment and therapies that we try and recommend to patients when they are undergoing therapy. We have the Wellness Center at Lourdes that is a place where patients can get information regarding nutrition and exercise. They have therapeutic massage and yoga. I think those are all important aspects of somebody’s recovery and well-being. I think sometimes it’s difficult to overcome apprehensions about those types of things that are not considered mainstream but I think they are vital components of overall health and recovery.
Melanie: Do people ask you for nutritional advice during treatment? If they are going through chemotherapy, maybe they are nauseous a lot, or radiation. Do they ask you what they should be doing nutritionally to help them along?
Dr. Fernandez: They certainly do. Unfortunately, there isn’t a "one plan fits all". I think it’s dependent on what particular side effects they’re having that mandate what they should do in the scope of adjusting their diet. I think calorie intake is an important aspect of good health and a balanced diet. There really isn’t a specific diet in the sense of “Hey, you need to eat this amount of fruits and vegetables” or “Avoid red meat versus fish and things like that". I think it’s very difficult to make significant dietary changes in the midst of everything else that is going on. I think it is a basic, “Hey, you need to eat well and balance your diet with everything that you know is supposed to be good for you.” Try to avoid the typical processed snacks and fast food kind of things that are not going to be overall good for you in the short term or in the long term.
Melanie: In the last few minutes, Dr. Fernandez, give your best advice about people going through chemotherapy, radiation and treatment for various cancers and what you want them to know about remaining physically fit or getting a little bit more fit and exercising than they did before their treatments.
Dr. Fernandez: I think there are different groups. There is the group that has always been healthy and they tend to remain focused and do the best they can in the scope of maintaining a good diet and exercise while they’re undergoing therapy. There is the in between group that needs a little bit of encouragement and they often will follow advice. Then, there is the group that has never really exercised. I think it has to be internalized what your ultimate goals are in treatment and after treatment – how you’re going to adapt your dietary habits and your exercise into your daily routine in the hopes that it’s going to potentially give you a better survival and a better recovery and function after treatment. You can advise but I think until it is internalized by those individuals who are not used to exercising or eating well, it’s somewhat of an uphill battle sometimes to really stress the importance of weight control and exercise.
Melanie: Dr. Fernandez, why should listeners come to Lourdes Health System for their care?
Dr. Fernandez: I think we have a family approach to care. We take care of patients like they were our family. I always tell people that the recommendations I’m making are the recommendations I would give to anybody in my family. That’s important. I think the other is compassion. We stress the humanistic aspect of care which, in this world of science and advancement, I think often gets forgotten. I think we also tend to look at the whole person in the scope of not only the particular disease they are being treated for and the treatments they are getting but what other aspects are affecting their quality of life and how we can improve that, whether it be through the Wellness Center or just spending the time to talk things out.
Melanie: Thank you so much, Dr. Fernandez, for being with us today. It’s great information. You’re listening to Lourdes Health Talk and for more information you can go to LourdesNet.org. That’s LourdesNet.org. This is Melanie Cole. Thanks so much for listening.
