De ce trebuie sa slabeasca pacientele cu cancer mamar?

  1. nutritie cancer mamar

Ai fost diagnosticata cu cancer de san?

 

Iata de ce trebuie sa slabesti daca esti supraponderala sau obeza sau daca erai normoponderala dar te-ai ingrasat pe parcursul tratamentului:

 

a) Obezitatea scade eficienta tratamentului oncologic in cazul pacientelor cu cancer de san:

 

  1. Pacientele obeze cu cancer de san triplu negativ fara afectare ganglionara au un prognostic mai prost decat pacientele normoponderale – Bonsang-Kitzis si colab., 2015
  2. Obezitatea scade supravietuirea pacientelor cu cancer de san ER+/PR±/HER2+ scazand raspunsul la tratamentul cu Tamoxifen si Herceptin – Pande si colab., 2014
  3. Raspunsul la chimioterapia neoadjuvanta este mai scazut in cazul pacientelor supraponderale si obeze cu cancer de san non-metastatic – Litton si colab., 2008
  4. Cresterea ponderala pe parcursul chimioterapiei creste riscul de recurenta si mortalitate, prognosticul optim fiind obtinut de pacientele care reusesc sa nu se ingrase pe parcursul chimioterapiei – Thivat, 2010
  5. Eficienta tratamentelor cu inhibitori de aromataza este mai scazuta in cazul pacientelor obeze aflate la menopauza la momentul diagnosticului – Ioannides si colab. 2014

 

b) Obezitatea creste riscul de metastaza in cazul pacientelor cu cancer de san:

 

  1. Obezitatea creste riscul de metastaza sis cade supravietuirea pacientelor cu cancere ER-/PR±/HER2+ – Mazarella si colab., 2013
  2. Obezitatea creste riscul de metastazelor pulmonare si hepatice, iar chimioterapia este mai eficienta in cazul pacientelor normoponderale – Osman si Hennessy, 2014
  3. Obezitatea creste riscul de metastaza – Strong si colab., 2015
  4. Obezitatea creste riscul de metastaza – Dowling si colab., 2016
  5. Obezitatea creste riscul de metastaze pulmonare – Nagahashi si colab., 2016
  6. Obezitatea creste riscul de metastaza si scade supravietuirea pacientelor cu cancer de san – Wu si colab., 2017

 

c) Obezitatea scade supravietuirea pacientelor cu cancer de san:

 

  1. Obezitatea este un factor independent care creste riscul de metastaze si mortalitate datorata cancerului de san, eficienta terapiilor adjvuvante fiind mai scazuta in cazul pacientelor supraponderale sau obeze – Ewertz si colab, 2010
  2. Obezitatea scade supravietuirea pacientelor cu cancer de san independent de afectarea ganglionara – Kaviani si colab., 2013
  3. Obezitatea si diabetul au un impact negative asupra duratei supravietuirii in cazul pacientelor cu cancer de san – Jiralerspong si colab., 2013
  4. Obezitatea reprezinta un factor de risc independent ce inrautateste prognosticul pacientelor cu cancer de san cu ER+/PR±/HER2- cu afectare ganglionara aflate la menopauza la momentul diagnosticului – Arce-Salinas si colab., 2014
  5. Obezitatea reprezinta un factor de risc independent ce inrautateste prognosticul pacientelor cu cancer de san cu ER+/PR±/HER2- cu afectare ganglionara aflate la menopauza la momentul diagnosticului – Scholtz si colab., 2015
  6. Obezitatea scade supravietuirea in cazul pacientelor < 40 de ani cu cancere de san ER- Copson si colab., 2015
  7. Obezitatea creste riscul de mortalitate in cazul pacientelor cu cancer de san, prognosticul imbunatatindu-se in cazul in care pacientele pierd grasime nu in cazul in care scad in greutate prin infometare asociata cu deshidratare si perdere de masa musculara – Chan si Norat, 2015

 

Studii citate:

 

Arce-Salinas, C., et al. “Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients.” Breast cancer research and treatment 146.1 (2014): 183-188.

 

Bonsang-Kitzis, Hélène, et al. “Beyond axillary lymph node metastasis, BMI and menopausal status are prognostic determinants for triple-negative breast cancer treated by neoadjuvant chemotherapy.” PloS one 10.12 (2015): e0144359.

 

Chan, Doris SM, and Teresa Norat. “Obesity and breast cancer: not only a risk factor of the disease.” Current treatment options in oncology 16.5 (2015): 1-17.

 

Copson, E. R., et al. “Obesity and the outcome of young breast cancer patients in the UK: the POSH study.” Annals of Oncology 26.1 (2015): 101-112.

 

Dowling, R. J. O., et al. “Abstract P2-02-09: Obesity associated factors are inversely associated with circulating tumor cells in metastatic breast cancer.” (2016): P2-02.

 

Ewertz, Marianne, et al. “Effect of obesity on prognosis after early-stage breast cancer.” Journal of Clinical Oncology 29.1 (2010): 25-31.

 

Ioannides, S. J., et al. “Effect of obesity on aromatase inhibitor efficacy in postmenopausal, hormone receptor-positive breast cancer: a systematic review.” Breast cancer research and treatment 147.2 (2014): 237-248.

 

Mazzarella, Luca, et al. “Obesity increases the incidence of distant metastases in oestrogen receptor-negative human epidermal growth factor receptor 2-positive breast cancer patients.” European Journal of Cancer 49.17 (2013): 3588-3597.

 

Nagahashi, M., et al. “Abstract P2-05-11: Sphingosine-1-phosphate signaling promotes metastatic niches and lung metastasis in obesity-related breast cancer.” (2016): P2-05.

 

Osman, Mohammed A., and Bryan T. Hennessy. “Obesity Correlation With Metastases Development and Response to First-Line Metastatic Chemotherapy in Breast Cancer.” Clinical Medicine Insights. Oncology 9 (2014): 105-112.

Kaviani, Ahmad, et al. “Effects of obesity on presentation of breast cancer, lymph node metastasis and patient survival: a retrospective review.” Asian Pac J Cancer Prev 14.4 (2013): 2225-9.

 

Pande, Mala, et al. “Association between germline single nucleotide polymorphisms in the PI3K-AKT-mTOR pathway, obesity, and breast cancer disease-free survival.” Breast cancer research and treatment 147.2 (2014): 381-387.

 

Jiralerspong, S., et al. “Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients.” Annals of oncology (2013): mdt224.

 

Litton, Jennifer K., et al. “Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer.” Journal of Clinical Oncology 26.25 (2008): 4072-4077.

 

Scholz, Christoph, et al. “Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer.” Breast cancer research and treatment 151.3 (2015): 569-576.

 

Strong, Amy L., et al. “Leptin produced by obese adipose stromal/stem cells enhances proliferation and metastasis of estrogen receptor positive breast cancers.” Breast Cancer Research 17.1 (2015): 112.

 

Thivat, Emilie, et al. “Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse.” BMC cancer 10.1 (2010): 648.

 

Wu, Yong, et al. “Aberrant phosphorylation of SMAD4 Thr277-mediated USP9x-SMAD4 interaction by free fatty acids promotes breast cancer metastasis.” Cancer Research (2017): canres-2012.

Despre Autor

Diana Artene

Am absolvit Facultatea de Medicina Carol Davila din Bucuresti in 2003, apoi m-am specializat in Nutritie Sportiva, Nutritie pentru Copii si Adolescenti si in Neurofiziologia Comportamentului Alimentar. Sunt doctorand in Nutritie Oncologica si Master in Stiintele Nutritiei acreditat de Ministerul Educatiei din Romania, Nutritionist Sportiv acreditat de Societatea Internationala de Nutritie Sportiva si membru acreditat al American Society for Nutrition.

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