Most women who want to lose weight just want to fit into a smaller dress or pair of jeans. But not Linda Ann Spurza of Lutz. She lost weight so she could live longer. • The mother of two young children was diagnosed with advanced breast cancer in October 2006. She found the lump herself, two weeks after a routine mammogram came back negative. Further testing revealed cancer was also in her sternum and spine. • Spurza had surgery and started several medications to keep the cancer quiet. A side effect was weight gain, something this trim, active 45-year-old had never battled before.
"The medicine put me into menopause at age 42," Spurza said. "As soon as I went into menopause, the weight started to come on, especially in the tummy."
Weight gain, particularly in the abdomen, is dangerous for breast cancer patients because it puts them at high risk for a recurrence. Spurza's doctor told her losing just 10 pounds would be almost as powerful as medication in reducing her risk of a recurrence. Spurza changed her diet, made physical activity a priority and lost 15 pounds.
"I will do anything," she said, "hang upside down from a tree, whatever, to get more time with my kids."
Being overweight has long been known to increase the risk of diabetes, heart disease and stroke, but more recently it has been linked to cancers of the uterus, colon, kidney, esophagus and breast (in postmenopausal women). There's also evidence that obesity may increase the risk for cancers of the gallbladder, pancreas, thyroid and ovaries.
Federal health officials estimate that 64 percent of adults, well more than 100 million Americans, are overweight or obese. According to the National Cancer Institute, 41,000 new cases of cancer annually may be related to obesity.
Scientists aren't sure why the two are linked, but they think being overweight elevates certain hormone levels in the body, which triggers an inflammatory process and promotes the growth of abnormal cells.
"We don't fully understand the mechanism by which obesity affects cancer risk yet,'' said Dr. Nagi Kumar, director of nutrition research at H. Lee Moffitt Cancer Center in Tampa. "There are many theories."
One thing is certain, Kumar said: The more body fat you have, the higher your risk for cancer.
"Talk to 98 percent of our patients in their 50s and 60s and they will tell you that they weigh at least 30 pounds more than they did in their 20s,'' she said
The weight factor is especially true for women and the risk of breast cancer.
"Gaining more than 10 pounds in the postmenopausal years puts you at higher risk; the more weight you gain, the higher that risk. That is one of the known causes of breast cancer," said Dr. Susan Minton, a breast cancer oncologist at Moffitt. The National Cancer Institute estimates that 11,000 to 18,000 breast cancer deaths per year in the United States might be prevented if women older than 50 maintained a normal body weight, a BMI below 25. That's why cancer specialists are particularly concerned about the obesity epidemic.
Dr. Shaila Raj, a Morton Plant Mease oncologist, said she doesn't wait long to discuss it with patients. After surgery, radiation and medical treatment, the next thing she addresses is weight management, diet and exercise.
"I make it a point to discuss prevention. I tell them having extra weight on is a risk factor for several cancers,'' she said.
Spurza took her post-cancer weight gain very seriously. She joined a group at Moffitt called RENEW 180: Recovery with Exercise, Nutrition, Education and Weight Management. Experts lead group and individual lessons on how to adopt a healthy lifestyle that will help participants beat cancer.
Now, her children ride their bikes while she tries to keep up on foot, three or four days a week. She works out with elastic bands for strength training the rest of the week. And though her diet is different now, she hasn't given up her favorite almond pastries or glasses of wine; she just doesn't have them every day.
She has two very important reasons to do everything in her power to prevent a recurrence of breast cancer: a 9-year-old son and a 6-year-old daughter.
"I live for my kids."