Unexplained weight loss can be a concerning symptom, sometimes signaling an underlying health issue like cancer. This article explores the complex relationship between cancer and weight loss, featuring personal stories and medical perspectives to shed light on this important topic.
Lymphoma and Unexplained Weight Loss
Night sweats, persistent fevers, and unexplained weight loss are common symptoms associated with lymphoma, encompassing both Hodgkin lymphoma and non-Hodgkin lymphoma. Lymphomas are broadly classified as aggressive or indolent. Aggressive lymphomas are characterized by their rapid growth and spread, potentially causing significant harm to tissues and organs. Due to their fast-growing nature, they are often linked to what are known as "B" symptoms. On the other hand, indolent lymphomas exhibit slow growth.
Several individuals have shared their experiences with lymphoma, highlighting the diverse ways the disease can manifest. Rob Moss, diagnosed with non-Hodgkin lymphoma at 49, initially noticed a lump in his throat that fluctuated in size. Shelby Wade, diagnosed with B-cell lymphoma at 23, experienced significant weight loss (20 pounds in a few weeks), shortness of breath, and extreme fatigue. Omar Dirani, diagnosed with non-Hodgkin lymphoma at 30, reported severe headaches, a persistent dry cough, weight loss, and night sweats. Jeff Johnson, diagnosed with Hodgkin lymphoma at 38, had a cough that persisted despite initially suspecting a cold or flu. Ann Sorhouse, diagnosed with non-Hodgkin lymphoma at 49, experienced back pains in the kidney area. Mallory Parrish, diagnosed with Hodgkin lymphoma at 32, noticed a lump on her collar bone, followed by intense itching.
Saira Ahmed, M.D., a lymphoma specialist, emphasizes the importance of seeking medical attention if multiple B symptoms persist for more than two weeks. Serious symptoms like difficulty breathing, chest pain, face or neck swelling, or difficulty swallowing warrant an immediate trip to the emergency room. These symptoms may indicate a condition caused by rapidly dying lymphoma cells, potentially leading to heart arrhythmia, kidney problems, and a general feeling of unwellness. Ahmed notes that approximately 40% to 50% of patients with aggressive lymphomas exhibit symptoms before diagnosis. While lymphoma symptoms can occur with any type or stage of the disease, they are more commonly observed in fast-growing lymphomas and when the disease is more advanced.
Lung Cancer and Incidental Discovery
Wei, a patient who had always been meticulous about preventive care, experienced unexplained weight loss despite maintaining her regular diet and exercise routine. Her doctor, Shih-Fan Sun, MD, ordered a CT scan to investigate the weight loss, which led to the incidental discovery of lung cancer. Wei's case highlights the importance of investigating unexplained weight loss, even in individuals with no apparent risk factors for lung cancer.
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According to Dr. Yanagawa, Wei's lung cancer was caught early due to the CT scan, allowing for a minimally invasive lung-preserving resection. Wei is grateful to her doctors, stating that her cancer would have gone undetected if not for the weight loss.
Dr. Sun emphasizes the need for more research to identify risk factors and demographic factors for lung cancer in never-smokers, similar to the screening benefits provided to patients with a smoking history through the National Lung Screening Trial. This trial demonstrated that low-dose CT scans could reduce the risk of dying from lung cancer by 20% in current and former smokers ages 55 to 74. However, other risk factors, such as occupational and environmental exposures, genetic susceptibility, and exposure to second-hand smoke, are more challenging to quantify and investigate.
Prostate Cancer and Weight Loss Programs
Steven Glode was diagnosed with prostate cancer in March 2020 and sought consultation at ECHN’s John A. DeQuattro Cancer Center in June 2020. Weighing 366.4 pounds with a BMI of 52.7 at the time, he began a weight loss program concurrently with his cancer treatments. With the support of Registered Dietitian Tracey Luciani, he was educated on portion control and intermittent fasting/time-restricted feeding. He also maintained food records and weighed himself daily. By October 2020, upon completing his prostate cancer treatments, Steven had lost a total of 95 pounds over 21 months, reducing his BMI to 39.
Steven attributes part of his success to his readiness to make a lifestyle change and his continued motivation. He emphasizes the importance of having a good support system, highlighting the caring and supportive approach of his wife and Tracey. Steven encourages others not to delay weight loss, emphasizing the positive impact it has had on his overall well-being and sleep quality.
Tracey Luciani screens all patients receiving radiation for cancer and offers weight loss services/support to those with a BMI >30. The goal is to help patients achieve a healthier weight and/or BMI to decrease the risk of cancer recurrence, improve/resolve existing co-morbidities, and prevent potential diseases/disorders. Recommendations are tailored to the individual, with most patients initially keeping food records and meeting with the RD weekly. Family members or friends are encouraged to participate in meetings to support the patient and learn about healthy weight loss. Accountability is maintained through ongoing weigh-ins and in-person meetings.
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Breast Cancer and Weight Loss Interventions
Obesity is a known risk factor for breast cancer recurrence, related health problems, and poor quality of life, highlighting the need for effective weight loss strategies after diagnosis and treatment. The Breast Cancer Weight Loss (BWEL) trial, a Phase III trial, investigated the effectiveness of a telephone-based weight-loss program plus health education compared to health education alone in patients with stage 2 or 3 HER2-negative breast cancer who had completed chemotherapy and radiation therapy.
The weight-loss program focused on reducing calorie intake and increasing exercise. After 12 months, 46.5% of patients in the weight loss intervention group lost 5% of their baseline body weight, and 22.5% lost 10%. In contrast, only 14.3% of those in the control group lost 5% of baseline body weight, and 5% lost 10%. Furthermore, 21.9% of controls gained more than 5% of baseline body weight compared to 8.2% in the weight loss intervention.
Jennifer Ligibel, MD, principal investigator on the study, emphasizes the difficulty of losing weight after a breast cancer diagnosis and the importance of providing patients with weight management support. The study demonstrated that weight loss was achievable regardless of education level, socioeconomic status, and treatment types, although less weight loss was observed in premenopausal, African American, and Latina patients, highlighting the need for further research to refine weight loss interventions for these groups.
The study provided the intervention in both English and Spanish and offered a toolbox of recipe recommendations to support various dietary preferences. Commercial partners supported the trial by donating activity monitors, wireless scales, meal replacement shakes, and food scales. The long-term goal of the BWEL study is to determine if the intervention reduces breast cancer recurrence.
Ovarian Cancer and Weight Loss in Young Women
Bethany, diagnosed with ovarian cancer at 19, shares her story to raise awareness that women of any age can develop ovarian cancer. In August 2017, she began experiencing weight loss and intermittent abdominal pains, which she initially dismissed. It was only after a rugby injury led to further investigation that a 30cm tumor was discovered.
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Bethany's experience highlights the importance of listening to one's body and seeking medical attention for persistent or unusual symptoms, regardless of age. Despite the challenges of her diagnosis and treatment, Bethany maintains a positive attitude and is grateful for the support of her family.
Colorectal Cancer and the Importance of Early Detection
One woman shares her journey with stage 3 colorectal cancer, emphasizing the importance of early detection and a positive attitude. Before her diagnosis, she experienced exhaustion, weakness, stomach cramps, changes in bathroom habits, and loss of appetite, which she initially attributed to poor dietary habits and stress. After being told she had a large mass in her lower abdomen, she knew it was cancer.
Her story highlights the importance of paying attention to bodily symptoms and seeking medical attention promptly. Despite the challenges of chemo, radiation, and surgery, she maintained a positive attitude and continued working throughout her treatment. She also emphasizes the importance of having a strong support system and avoiding cancer statistics.
Lung Cancer in a Long-Term Smoker
George, a 76-year-old long-term smoker, was diagnosed with lung cancer after his wife noticed he was losing weight and had a slight ongoing cough. An X-ray and CT scan revealed a cancerous tumor in his right lung. He underwent surgery to remove the tumor, the upper part of the right lung, and surrounding lymph nodes.
Despite facing health challenges during the COVID-19 pandemic, George decided to proceed with chemotherapy as a preventative measure. He emphasizes the importance of having a strong support system and maintaining a positive attitude. George remains clear of cancer and is determined to regain his quality of life.
Pancreatic Cancer and Cachexia
Cachexia, characterized by extreme loss of muscle and fat, is a common and debilitating condition associated with pancreatic cancer. The wife of a man who died from pancreatic cancer shares her experience with cachexia, highlighting the challenges of maintaining weight and quality of life in the face of this condition.
Her husband experienced lowered digestive ability, stents, bypass surgery, a change in gut biome, heavy antibiotics, chemotherapy, infections, and thrush in the mouth, all of which contributed to his inability to eat and maintain weight. Despite efforts to provide tasty and easily swallowed food, he struggled to eat, leading to frustration and despair for both him and his caregivers.
She wishes she had known about cachexia sooner, as it would have alleviated guilt and allowed them to focus on quality, not quantity, of food. She emphasizes the need for more awareness of cachexia among medical professionals and the public, as well as more research into this poorly understood area.