Obese and just diagnosed with breast cancer

joone_9

Hoping to connect with others who either were or are obese (on a weight loss journey) when facing treatment for breast cancer. Did a quick search and didn’t see any active groups out there on MFP. I would like to hear experiences with things to expect, limitations on options for reconstruction and any other thing that comes to mind on how being obese affects the way you were treated for breast cancer or things you perhaps struggled with on your weight loss journey that includes fighting cancer.

The_Elephant_Man

@joone_9 I am sorry for your diagnosis. Think positive. You can do this!!!

AnnPT77

I was diagnosed with stage 3 (locally advanced) breast cancer while I was class 1 obese, age 44. I had 5 tumors in my left breast (largest 3.1 cm), 1 in my right breast (around 1.1cm), and one positive lymph node (left). I had bilateral mastectomies (no reconstruction - not interested in extra surgery, but many of my friends have had reconstruction** - every woman needs to make her own preferred choices!), 6 months of chemotherapy (4 x 3 weeks adriamycin/cytoxan, 4 x 3 weeks Taxol), radiation therapy (6 weeks, every weekday), 2 years of Tamoxifen, 5 years of Arimidex . . .

. . . starting 20 years ago, September/October 2000. Currently, no evidence of disease, either metastatic, or new primaries. I got active shortly after treatment (diagnosed at age 45), and became a masters athlete, competing in rowing, starting in 2002. (Note: In rowing, "masters" means "older", not "highly skilled! 😉). Despite working out regularly, (which in itself has well-documented survivorship benefits), becoming fairly fit, I stayed obese until 2015. At that point, something finally clicked, and I started losing weight. Within a bit less than a year, I was at a healthy weight (at age 60). I've maintained a healthy weight since - after around 30 years previously of obesity - using MFP. I'm as active as ever, and feeling *great*, now, at age 65, 5'5", 124.8 pounds this morning.

** I've been a member of a breast cancer rowing team, and a long-term participant in an in-person breast cancer support group, so many of my friends are survivors, including the majority of my close friends. Therefore, I know women who've made various treatment choices. I wanted bilateral mastectomies, no reconstruction, from the start, although at first only diagnosed with tumors in one breast. (My mother had died, at 81, from breast cancer, as part of the context.) I was also trained as a volunteer peer support person, which gave me more information about treatments and such.

I sometimes joke that in order to get what I wanted, I had to develop a tumor in the other breast. My surgeon didn't want to do the 2nd mastectomy just as a precaution, which is something I wanted. However, they did more scans, and found a suspicious area in the right breast, too. My surgeon and I agreed that he would biopsy the suspicious area while I was on the operating table for the initial mastectomy, and proceed with mastectomy on the second breast if the suspicious area was malignant. I went into anaesthesia not knowing if I'd wake up with one breast, or zero (which I preferred). In the recovery room, he told me the suspicious area was malignant, so I had the bilateral mastectomies I'd wanted all along. I'm happy with my choice, in my circumstances. I used prostheses at work before I was retired (easy, comfortable), but used them less often in private life. Now I only use them for the rare dress-up occasion, because fancy women's clothes fit better with breasts. For me, for a variety of reasons, it's perfect.

Your treatment team should offer you options, if your case permits. Mastectomy plus radiation (as I had on one side) limits reconstruction options, for technical medical reasons. Beyond that, options can differ depending on where you live, and whether you can afford options (if needed/desired) beyond what your health coverage includes. In the US, where I am, most women with less advanced disease (but health insurance) can either elect mastectomy + reconstruction (of which there are many types) or lumpectomy + radiation. There are partial-reconstruction options for extreme lumpectomies, or partial-protheses available to fill out the bra.

As I implied, I never wanted reconstruction. That's a personal choice, though I won't go into my thought process unless you're interested. I know women who've had various types (implants, own-tissue operations; lumpectomy with reduction on the opposite breast to match - which women with large breasts sometimes want; etc.).

I usually tell people that cancer treatment was the worst hobby I ever had, worse than adventure travel, worse than extreme sports (neither of which I ever did! 😆). The key point is that cancer treatment wasn't something I'd do for entertainment. But, it also wasn't as bad as popular media had led me to expect (they usually do stories about heroic women undergoing some Great Ordeal, worse than anything they've ever experienced). Even though I was sicker during chemotherapy than most women usually get these days (based on what I've heard in my support group), I was never sicker than I'd previously experienced at other times in life for short bouts with flu or whatever. The difference was that chemotherapy was a long slog, with (after the first "learn about it" round) predictable stages of feeling yucky for a while, then gradually better, then yucky for a bit again. Take it day by day, it's doable.

I hope I'm not scaring you. The earlier the stage you're diagnosed, the less extreme the treatment. But, the stage/type I had gets a person about the max treatment. It was doable. Not fun, but doable. There are strategies for dealing with the side effects. If you need that kind of treatment, you can do it. If you need something short of the extreme, so much the better.

I think the coverage of breast cancer in magazines, blogs, TV, makes it seem extra scary, because that makes for a more dramatic story. Reality is different, and thousands of women handle it, and come out the other side stronger, better, and healthy.

If you're just starting treatment, your treatment team may ask you to try to maintain your weight pretty steady if you can, until treatment is complete. (Whatever they say, listen.) The rational for "hold steady" is that surgery/chemo/radiation is a stress on the body, and dieting is also a stress. During treatment, you want to prioritize healing, and healing requires calories, too. They may also have dietary guidance, and it may differ from what you might expect (for example, in some scenarios, big doses of antioxidant vitamin supplements can be non-ideal). Communicate with your treatment team, take their advice, which will both current medically, and tailored to your specific case.

Wishing you all the best, in this challenge. If you have questions about my experience, please ask.

springlering62

@AnnPT77 Ann, bosoms or not, you are a goddess of kindness, thoughtfulness and good advice.

OP, may everything work out for you positively, and when this is all over, you simply remember it as "could have been worse, now let's get on with things". In my mind that's always the best outcome. Hugs.

AnnPT77

Afterthinking (if that's not a word, it should be):

I should've talked more about radiation therapy. For breast cancer, there are now multiple modes, for different cases. The traditional-ish type that I had takes around six weeks, short session every weekday, typically. (Takes longer to get undressed, into the hospital gown, then redressed, usually.) Some newer types, in which tiny radioactive bits are implanted near the tumor site temporarily, take much less calendar time, so easier logistics (vs. going to treatment center every day).

Many of the scary media stories about radiation treatment are about other cancer types. Effects depend super much on what body parts require radiation. Radiation to things like throat or digestive tract - essential organs for daily functioning - can have significant side effects (via swelling and such), be quite difficult.

Breast cancer radiation treatments generally affect only breast tissue, maybe some chest/underarm muscle (depending on tumor location (s)). The side effects are rarely severe.

Because I did a super good job getting cancer 🙄 (advanced, multi-site), my radiation therapy was quite extensive: 5 fields, some on upper chest, some under arm, some on back of shoulder.

Side effects, for me: Mild cumulative fatigue, local burn right near the end of treatment (not the whole radiated ares, small part) It was not worse than really bad sunburns I've had a handful of times in my life (and this was what I experienced *after* 6 months of quite physically depleting chemo, so went into it fatigued). IMU, sometimes the "sunburning" effect can be a bit worse if post-mastectomy with larger breasts, because the overlap of breast tissue with chest tissue is complicating (can't wear a bra, especially not underwire, through whole calendar period).

Breast cancer radiation therapy is rarely, rarely a big deal, other than the logistics of getting there. (The rare exceptions are mostly about areas of burn getting secondary infection.)

Long term, I had some scar tissue under my chest skin (feels harder, tighter), and needed physical therapy for that. (A few people have more of that, like difficulty with raising arm overhead (frozen shoulder), but PT works. Mine never interfered with daily life tasks at all, but the tightness/pulling was contributing to some minor poor body alignment that long term caused me a little musculoskeletal discomfort. PT relieved that.

So, radiation therapy for breast cancer: Mostly very manageable, well tolerated. Still an annoying hobby, but temporary.

Best wishes!