While researchers believe there is a link between obesity and cancer, there is, surprisingly, another reason to be concerned: Overweight cancer patients are undertreated.
Practice pattern studies demonstrate that up to 40 percent of obese patients receive limited chemotherapy doses that are not based on actual body weight: They are receiving less than 85 percent of the proper dose for their weight.
A panel of experts from ASCO is looking to change this chemotherapy dosing by implementing new guidelines so that these patients receive full, weight-based doses. Capping the chemotherapy dose may be contributing to a higher mortality rate, along with recurrence rates in obese patients.
Gary Lyman, a Duke University oncologist who led the panel, said that a 20 percent reduction in chemotherapy doses can lower remission and cure rates by half, along with increasing drug resistance.
Jennifer Griggs, a University of Michigan breast cancer specialist who also worked on the guidelines, claims that giving too little chemo "could make it as if they didn't even get treated at all… so they go through the whole ordeal with no benefit, in the extreme case."
Interestingly, studies also show that obese cancer patients may be less likely to develop dangerous side effects such as pancytopenia, or they may even be able to metabolize the drugs better than someone that's at a lower body weight.
Even if an obese patient does experience a chemo-related side effect, and a temporary dose reduction is necessary, increasing the dose the next time around is important so that the patient can experience maximum benefit from the drug.
So why are we so focused on this issue now? Well, considering the rate of obesity has skyrocketed in the US, being overweight has become the new normal, and we need to adjust our chemotherapy dosing accordingly.
Have you noticed a trend among your obese cancer patients in regard to survival status? Do you feel that these patients experience fewer side effects when compared to those cancer patients of normal weight?