Weight-Related Talks: Important, But Delicate in the Breast Cancer Space

Clinicians often have conversations about the importance of proper exercise and nutrition with their patients, but many become uncomfortable when talking about weight — particularly the impact that being overweight or obese can have on breast cancer outcomes. These discussions are very important, though, and there are personal factors that should be considered when chatting with a patient.

“One size does not fit all. You cannot have the same conversation with every patient,” said Kirsten A. Nyrop, PhD, assistant professor and deputy director for research in the Geriatric Oncology Program at UNC-Chapel Hill.

Nyrop recently led research on weight-related conversations in female breast cancer survivors. To gather data, she ran focus groups in which survivors talked about their experiences. Nyrop discussed the findings in an interview with Oncology Nursing News.

“The weight conversation is very sensitive already, and women in our study say they feel that the topic is not broached, because the clinicians are sensitive to that and they don’t want to be offensive,” Nyrop said. “But on the other hand, if it’s important to the quality of their survivorship and potentially even their prognosis, [survivors] feel that you should definitely bring it up.”

Instead of giving patients a blanket statement about the importance of maintaining a healthy weight, health care providers should investigate why patients gained weight in the first place. Some might have been struggling with their weight their whole life, while others had cancer or treatment factors that contributed.

“Many [survivors] are having lingering pain or depression that may keep them from exercising,” Nyrop said. “So, in exploring the physical side of things, it’s important not to talk about healthy weight, but instead about healthy behaviors and the overall concept of health rather than just the weight.”

When discussing nutrition, ask patients how they eat and figure out how they’d like to go about improving their diet — and listen. Some patients may want to have a handout with information, others may want to talk with their nurse or other providers, and some may see a nutritionist.

“[Clinicians can say] something like, ‘This is a good time to avoid gaining weight,’ rather than ‘You need to go on a diet and get serious,’” Nyrop said. “It’s softening the message, but it’s a realistic message and within the realm of what they can do.”

Nyrop mentioned that the United States — and Western countries in general — must address and improve the obesity crisis, which, in turn, would lead to better outcomes for cancers and other chronic diseases alike.

“Clinicians are going to have to go outside of their comfort zones to help their patients with obesity,” she said.