Bariatric surgery offers hope in endometrial cancer prevention

Posted Online: June 02, 2014, 12:43 pm
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By Bev Bennett, CTW Features
Obese women are more than two times more likely than normal-weight women to develop endometrial cancer, which forms in the tissue lining of the uterus.
Unfortunately, many women find it next to impossible to reach a healthier weight through diet alone.
For them bariatric surgery may be an option to reduce the risk of uterine cancer, including endometrial cancer, which accounts for nearly all cancers of the uterus.
A recent study shows that women who underwent bariatric weight loss surgery had a 70 percent lower risk of endometrial cancer, and an even lower risk if they kept the weight off, according to Dr. Kristy Ward, gynecologic oncology fellow, UC San Diego Moores Cancer Center, San Diego, Calif.
The procedure "reduces the risk of endometrial and maybe even other cancers," says Dr. Ward, lead author of the study on gynecologic cancer prevention in obese women, based on more than 7 million hospital admissions and published in the journal Gynecologic Oncology.
Keeping weight off after surgery improves the odds even more, according to Dr. Ward's research.
That can be challenging, however, especially after a lifetime of overeating, she says.
That's why dietitians offer nutrition information and diet counseling to manage long-term weight loss.
"People who opt for bariatric surgery have tried more than a dozen attempts before (to lose weight)," says Jessica Crandall, registered dietitian nutritionist, certified diabetes educator, Academy of Nutrition and Dietetics Spokesperson.
"It's important for them to be supported to get the right amount of nutrition in the right format," says Crandall, who works with a lot of bariatric surgery patients.
Some of the advice nutrition experts offer is specific to people who've undergone bariatric surgery, but other recommendations can help any woman who's trying to lose weight and reduce her risk of uterine cancer.
First, a woman must learn why her overeating happens.
If you coped with difficult feelings by eating, you can't continue that habit.
"If you gorged on food before, you can't now. It won't feel good," says Jill Fisher, registered dietitian, Bariatric and Metabolic Institute, UC San Diego.
If you ate to relieve stress, you need to find other strategies.
"Food acts as a relaxant. Eating is calming. You can take a walk instead or do something else calming," Crandall says.
Find help for healthier eating.
Support groups can help you stick to a healthful eating plan.
You can find a buddy who will exercise with you or encourage you to follow your diet.
Your group may also include weigh-ins, which can be beneficial. Patients at the Bariatric and Metabolic Institute weigh in weekly, according to Fisher.
Embrace healthier food choices and an appropriate meal schedule to prevent a hunger/binge cycle.
You can't skip breakfast and lunch and gorge at dinner. Your body can't handle it.
"The stomach shrunk. People should be eating smaller meals," Fisher says.
Eating four to six mini meals prevents binging, Crandall says.
The smaller meals should include protein for satiety and to help preserve muscle mass.
Crandall advises her post-surgery clients to get 60 to 80 grams of protein a day (for reference, one large egg has about 6 grams of protein).
At the same time both dietitians recommend cutting back on starches.
Because there's less room in the stomach, it's important to concentrate on foods that are rich sources of nutrients, such as lean protein and vegetables.
"I don't encourage starches, such as bread and pasta and tortillas, because they're high in calories and not a lot of protein," Fisher says.


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