Minimizing Obesity's Impact On Ovarian Cancer Survival
Main Category: Ovarian CancerAlso Included In: Cancer / Oncology; Obesity / Weight Loss / Fitness
Article Date: 02 Jan 2009 - 2:00 PDT
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Obesity affects health in several ways, but new research shows obesity can have minimal impact on ovarian cancer survival. A study by researchers at the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center found ovarian cancer survival rates are the same for obese and non-obese women if their chemotherapy doses are closely matched to individual weight.
The findings contradict earlier research that shows obese women have lower ovarian cancer survival rates compared to non-obese patients. In the UAB study, such survival disparity disappeared when chemo doses were calculated by actual body weight rather than a different dosing standard, said Kellie Matthews, M.D., a UAB gynecologic oncologist and lead author on the new study.
"Often chemotherapy dosing is calculated using 'ideal' body weight as a guide. We found using actual body weight works best, and it wipes away much of the difference in survival rates between obese and non-obese patients," Matthews said.
The results are published online in the journal Gynecologic Oncology.
Researchers reviewed the medical records of 304 patients diagnosed with an aggressive form of the disease called epithelial ovarian cancer. Patients were of similar cancer stage and grade, and all had surgery followed by chemo.
The analysis showed that when actual body weight was used in chemo dosing the overall survival is 40 months for non-obese patients and 47 months for obese patients, not a significant difference, Matthews said. Similar outcomes are seen in obese and non-obese cancer survivors being monitored for recurrence of their ovarian cancer.
UAB's chemo dosing formula includes actual weight, body mass index (BMI) and other factors, Mathews said. Obesity is defined as a BMI (BMI: kg/m2) of 30 or more.
The study authors acknowledged that while it was possible to follow this formula and remove obesity as a negative indicator for ovarian cancer survival, obesity still puts women at increased risk for complications related to cancer surgery, such as greater blood loss and stubborn-to-heal incisions. Also, research shows obese women are more likely to have other health problems such as diabetes and cardiovascular disease that may impact cancer treatment.
The Gynecologic Oncology study was collaboration between UAB's Division of Gynecologic Oncology, the Division of Hematology/Oncology and the University of South Alabama's Mitchell Cancer Institute in Mobile.
Source
Troy Goodman
University of Alabama at Birmingham
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Obesity And Cancer Is More Than Dosing
posted by John on 31 Mar 2009 at 3:19 pmAnother accepted manner of dosing obese patients is by using an adjusted body weight, which factors in both actual and ideal body weights. Pharmacokinetics vary quite a bit from chemotherapy to chemotherapy.
As with much of "western" medicine, actually examining the patient is never mentioned, and it is impossible to examine many obese patients -- a very important aspect of surveillance and identification of early recurrence, which is common in ovary cancer.
Performance status, another prognostic marker, is always impaired in obesity, as are co-morbidities such as diabetes that were noted to be increased in incidence in this population. Further, it's not just about accurate dosing of the chemotherapy, it's about accurately dosing supportive medications, such as prophylactic anti-nausea medications and even cytokines to support white and red blood cells.
Western medicine continues to accomodate obesity as political correctness, and even legally as discrimination. We have larger and larger wheelchairs, stronger beds, CT and MRI gantries that hold larger patients, larger blood pressure cuffs, wider doors, bigger toilets, bigger gurneys, and even hydraulic lifts for the poor broken nurses and physical therapists. Appropriately-sized patients feel absolutely lost in these settings!
Not only does this cost the healthcare system tremendously, obesity does cause many other medical problems, as well as decreased overall life expectancy. It is a tremendously vicious cycle, and one we really need to stop accommodating.
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