541-323-38334 Hidden Keys to Weight Loss for Cancer Survivors: Beyond Diet and Exercise
Q: I’m a 2-year oral cancer survivor. I’m finally feeling recovered after treatment, which included radiation, chemotherapy, and surgery. Since my diagnosis, I’ve been eating better and exercising more. However, I’ve hit a plateau in my weight and the last 20 pounds won’t budge. I’m still tired, my metabolism is slow, and I don’t sleep well. I’m wondering if there’s anything about my cancer history that might be affecting my ability to lose weight. Beyond diet and exercise, is there anything that I should be doing?
— Sarah in Dallas, Texas
A:
Cancer survivors have unique needs in a weight loss program. The right program includes an active lifestyle, nourishing food, and restful sleep. These components can produce lasting weight loss while significantly reducing your risk of cancer recurrence.
If you’ve followed this foundational program for 2 months without results, then it’s time to look for hidden causes of fat retention.
For cancer survivors, there are 4 hidden keys to weight loss:
1. Reset the Thermostat
2. Recharge
3. Open the Fat Stores
4. Put Out the Fire
Reset the thermostat
If your metabolism has been sluggish since cancer treatment, it may be time to check the thermostat. The thyroid is the thermostat for your fat-burning furnace.
Radiation to the lower neck can cause inflammation and reduced blood supply in the thyroid, resulting in hypothyroid. In fact, 74% of head and neck cancer survivors have hypothyroidism within 10 years after treatment. [1] People with radiation treatment for cancers of the thyroid, breast, upper lung or esophageal, or lymphoma can also be affected. Thyroid damage is more common with older 2-dimensional radiation therapy techniques than with modern image-guided 3 dimensional radiation. However, image guided radiation still causes hypothyroidism in people with cancers of the nose and throat. [2] [3]
There are two steps to finding out if your thyroid might be affected: ask your doctor, then get a blood test. Your radiation oncologist can tell you whether your thyroid was involved in the radiation therapy treatment field. A doctor can then follow this up with a thyroid panel blood test to check for your thyroid function. I encourage you to get a full panel, not just the TSH.
Hypothyroid can be treated with thyroid hormone replacement therapy. If you’re deficient in thyroid hormone, this treatment can provide a surge of energy and steady weight loss within weeks of starting hormone replacement.
Recharge
It looks like you’ve been having persistent fatigue and insomnia since cancer treatment. This fatigue can make it difficult to exercise. Sleep deprivation also imbalances the appetite regulators leptin and ghrelin. [4]
There can be many causes for fatigue and insomnia. However, there’s one cause that’s unique to cancer survivors that you need to know about: adrenal fatigue from steroid or Megace therapy.
Most chemotherapy treatments include intravenous steroids. Steroids are a life-saving part of chemotherapy. They prevent deadly allergic reactions to treatment, and also prevent debilitating nausea. However, steroids also suppress adrenal gland function. The appetite stimulant Megace can also cause adrenal insufficiency. [5] For most cancer survivors, the adrenal glands gradually recover after discontinuing steroids or Megace. Yet, for some people, their adrenals don’t bounce back.
The adrenal glands control energy and blood sugar metabolism, so it is more difficult to lose weight when the adrenals are deficient. If you have persistent fatigue and weight gain after completing chemotherapy treatment, ask your N.D. about ruling out adrenal fatigue as a hidden cause of weight gain.
Open the Fat Stores
When healthy diet and an active lifestyle don’t lead to fat loss, check for imbalances in the fat storage hormone. Insulin stores calories away as fat and muscle. Our bodies are designed to keep steady blood sugar and insulin levels. However, if insulin spikes too often, the cells stop responding. The pancreas reacts by releasing even more insulin, and the cycle repeats. This produces insulin resistance. Insulin resistance blocks fat loss. Worse yet, it’s a powerful promoter of tumor growth. [6],[7]
Causes of insulin resistance can include steroids, anti-androgen therapy used for prostate cancer, inactivity during treatment, or diet. Often, people eat sugars and starches during cancer treatment due to nausea, difficulty swallowing or a desire for comfort food. This is understandable. However, it is important to reset insulin levels after treatment is complete.
For cancer survivors, it is critical to identify and resolve insulin resistance. Insulin resistance can be diagnosed with a waist-to-hip ratio combined with blood tests such as glucose, insulin, lipids, and hemoglobin A1C. I recommend checking glucose and insulin both fasting and after a starchy meal. Your naturopathic physician can help you determine if insulin resistance is getting in the way of healthy weight loss.
Insulin resistance can be reversed. A low glycemic diet and supplements to restore insulin sensitivity are the core of the program. These insulin sensitizers may also prevent cancer recurrence. For example, several studies indicate that Metformin and berberine may reduce recurrence in ovarian cancer. [8]
Put out the fire
If you’ve got achy muscles and joints, clogged arteries, or belly fat, you may be on fire. The fire is inflammation, and it’s blocking your ability to lose weight. Fat cells activate inflammatory signals like TNF-alpha and NF-kappa-beta. Inflammation contributes to insulin resistance, which then blocks weight loss. [9] Worse yet, inflammation also contributes to cancer recurrence.
Here are some ways to put out the fire:
Eat to quench the fire. Choose a rainbow of plants. Add in nuts and seeds, oily fish, avocado, and olive oil. Avoid “fiery” foods such as sugar, simple starches, trans fats, and red meat.
Get spicy. Herbs and spices are powerful yet gentle antiinflammatories. Choose ginger, turmeric, black pepper, and fennel.
An aspirin a day. Several studies indicate that a baby aspirin prevents recurrence of prostate and colorectal cancer via decreasing inflammation. [10] [11] Talk with your doctor before starting any medication.
Conclusion
Nourishment, activity, and restful sleep are the foundation for healthy weight loss. However, if you’re following this program and the weight won’t budge, there may be hidden causes of fat retention. A naturopathic oncologist can help you to determine if side effects of cancer therapy may be affecting your ability to lose weight. Correcting hidden causes of fat retention can also enhance prevention of cancer recurrence.