Cancer Treatment and Waistlines: Give Me Back My Body!

PJ Hamel Health Guide
  • “The doctors and insurances companies woke up enough to realize that your breasts are a huge part of your self-image, so when you have a mastectomy, insurance pays for reconstruction. And then they finally understood that being bald is a body image issue, too, so they pay for wigs. When are they going to realize that being fat is just as bad as losing a breast or your hair?”

    That was the complaint of one of the women I was with last week, as we enjoyed our monthly get-together at a local pub. We live near a small, expensive college. Our table of women, ranging from late 30s to early 60s, was right at the door of the pub. And as we sat, talked, and drank, we were treated to a passing parade of young “hard-bodies”–college kids, both male and female, in their physical prime. They were well-dressed and perfectly groomed, in that way that whispers “money;” not an extra ounce of flab showed anywhere.
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    Jealous? Well, not really. I don’t think any of us, once we’ve gotten through those challenging years of dating (a.k.a. “hooking up”) and figuring out what to DO with your life, wants to go back. But we all miss the relative ease with which we could make ourselves look pretty good in the morning. We miss being able to have a couple of drinks or enjoy a handful of potato chips, and not see the calories migrate immediately to our hips. And the consensus among us is that cancer treatment is the major culprit that’s raising our exasperation as it puts inches on our waistline.

    “I do 40 minutes on the NordicTrak every single day. I do South Beach AND Weight Watchers. I ski every weekend. And I haven’t lost an ounce!” Jen lamented her inability to get back the body she’d had before inflammatory breast cancer at age 36 had taken 18 months out of her life, and added 15 pounds to her frame. (“And besides, since I got the tummy tuck during reconstruction, it’s probably more like 20 pounds!”) Yes, she’s frustrated with the weight gain; but as she talked, I could see she was just as frustrated with her health care team’s failure to take her concerns seriously.

    “Dr. X says it’s this, it’s that, it’s menopause, whatever, and he won’t prescribe a diet drug, even though he says it might help me, and certainly won’t hurt. And I’ve been blown off by the dietitian at the hospital twice. Hey, I’m still in circulation; I just want to get these pounds off my butt!" We sat and nodded our heads in agreement; what woman doesn’t want to get pounds off her butt? “My doctor told me I was probably feeling sorry for myself and eating too much," sighed Barb, sitting next to Jen. “Yeah, they told me it was a natural part of aging,” laughed Cindy, a tall, striking woman in her 50s. “I gained 10 pounds like THAT when I started tamoxifen,” Jane chipped in. “And my doctor said, ‘There’s no evidence that tamoxifen promotes weight gain.’ So why are we all sitting here, all of us on or have been on tamoxifen, and all of us having put on the pounds?”

  • Body image includes more than just breasts and hair: in our American society, being overweight is considered unattractive. And all of us at the table concurred that we don’t know a single woman who, having gone through breast cancer treatment, hasn’t put on weight and been unable to shed it–till years later, if ever. Maybe it’s just something we live with: the two or three or four years of drugs after treatment are going to pack some extra pounds on our already beaten-up bodies. And maybe it’s not simply the drugs, but the combination of chemo, radiation, a shift in our metabolism–all of the above. But whatever the cause, it would be nice for the connection between cancer treatment and weight gain to be acknowledged as something more than “overeating because you feel sorry for yourself” or “the natural effects of aging.” Until we ALL agree that weight gain is just as embarrassing as losing a breast or your hair, not much will be done to address this particular crummy side effect of breast cancer.

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Published On: March 15, 2007