Cancer survivorship, excess body fatness and weight-loss intervention—where are we in 2020? (2024)

1. “DCCPS: OCS: About Cancer Survivorship Research: Survivorship Definitions”. (Office of Cancer Survivorship of the US National Cancer Institute, 2006).

2. Macmillan cancer Support. Cancer cash crisis—counting the cost of care beyond treatment. https://www.macmillan.org.uk/documents/campaigns/cancercashcrisisreport-macmillandecember2015.pdf (2015).

3. Maddams, J., Utley, M. & Møller, H. Projections of cancer prevalence in the United Kingdom, 2010–2040. Br. J. Cancer 107, 1195–1202 (2012).

   CAS PubMed PubMed Central Google Scholar

4. Allemani, C. & Coleman, M. P. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme. Cancer 123, 4977–4981 (2017).

   PubMed Google Scholar

5. World Health Organisation. Obesity and Overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (WHO, 2018).

6. International Agency for Research on Cancer. Absence of Excess Body Fatness. http://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Absence-Of-Excess-Body-Fatness-2018 (IARC, 2018).

7. Hopkins, B. D., Goncalves, M. D. & Cantley, L. C. Obesity and cancer mechanisms: cancer metabolism. J. Clin. Oncol. 34, 4277–4283 (2016).

   CAS PubMed PubMed Central Google Scholar

8. Quail, D. F. & Dannenberg, A. J. The obese adipose tissue microenvironment in cancer development and progression. Nat. Rev. Endocrinol. Mar. 15, 139–154 (2019).

   Google Scholar

9. Pietrocola, F., Pol, J., Vacchelli, E., Rao, S., Enot, D. P., Baracco, E. E. et al. Caloric restriction mimetics enhance anticancer immunosurveillance. Cancer Cell 30, 147–160 (2016).

   CAS PubMed PubMed Central Google Scholar

10. World Cancer Research Fund. Cancer survivors: evidence on survivors of breast and other cancers. https://www.wcrf.org/dietandcancer/cancer-survivors (2018).

11. Arends, J., Bachmann, P., Baracos, V., Barthelemey, N., Bertz, H., Bozzetti, F. et al. ESPEN guidelines on nutrition in cancer patients. Clin. Nutr. 36, 11–48 (2017).

    PubMed Google Scholar

12. El-Shami, K., Oeffinger, K. C., Erb, N. L., Willis, A., Bretsch, J. K., Pratt-Chapman, M. L. et al. American cancer society colorectal cancer survivorship care guidelines. CA: Cancer J. Clin. 65, 428–455 (2015).

    Google Scholar

13. Anderson, A. S., Caswell, S., Wells, M. & Steele, R. J. Obesity and lifestyle advice in colorectal cancer survivors—how well are clinicians prepared? Colorectal Dis. 15, 949–957 (2013).

    CAS PubMed Google Scholar

14. Koutoukidis, D. A., Lopes, S., Fisher, A., Williams, K., Croker, H. & Beeken, R. J. Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals. BMJ Open 8, e020313 (2018).

    PubMed PubMed Central Google Scholar

15. Markham, M. J., Wachter, K., Agarwal, N., Bertagnolli, M. M., Chang, S. M., Dale, W. et al. Clinical cancer advances 2020: annual report on progress against cancer from the American Society of Clinical Oncology. J. Clin. Oncol. 38, 10, 1081 (2020).

    PubMed Google Scholar

16. Cao, F., Li, F., Shi, L., Zhang, L., Ma, T. & Zhang, G. Mortality trends of colorectal cancer among overweight patients at the global and national levels. Int. J. Colorectal Dis. https://doi.org/10.1007/s00384-019-03371-6 (2019)

17. Chan, D. S., Vieira, A. R., Aune, D., Bandera, E. V., Greenwood, D. C., McTiernan, A. et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann. Oncol. 25, 1901–1914 (2014).

    CAS PubMed PubMed Central Google Scholar

18. Westhoff, E., Witjes, J. A., Fleshner, N. E., Lerner, S. P., Shariat, S. F., Steineck, G. et al. Body mass index, diet-related factors, and bladder cancer prognosis: a systematic review and meta-analysis. Bladder Cancer 4, 91–112 (2018).

    PubMed PubMed Central Google Scholar

19. Cao, Y. & Ma, J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev. Res. 4, 486–501 (2011).

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    CAS Google Scholar

20. Gupta, A., Das, A., Majumder, K., Arora, N., Mayo, H. G., Singh, P. P. et al. Obesity is independently associated with increased risk of hepatocellular cancer-related mortality: a systematic review and meta-analysis. Am. J. Clin. Oncol. 41, 874–881 (2018).

    PubMed PubMed Central Google Scholar

21. Park, Y., Peterson, L. L. & Colditz, G. A. The plausibility of obesity paradox in cancer-point. Cancer Res. 78, 1898–1903 (2018).

    CAS PubMed PubMed Central Google Scholar

22. Cespedes Feliciano, E. M., Kroenke, C. H. & Caan, B. J. The obesity paradox in cancer: how important is muscle? Annu. Rev. Nutr. 38, 357–379 (2018).

    CAS PubMed Google Scholar

23. Walter, V., Jansen, L., Hoffmeister, M., Ulrich, A., Roth, W., Bläker, H. et al. Prognostic relevance of prediagnostic weight loss and overweight at diagnosis in patients with colorectal cancer. Am. J. Clin. Nutr. 104, 1110–1120 (2016).

    CAS PubMed Google Scholar

24. Van Arsdale, A., Miller, D. T., Kuo, D. Y., Isani, S., Sanchez, L. & Nevadunsky, N. S. Association of obesity with survival in patients with endometrial cancer. Gynecol. Oncol. 154, 156–162 (2019).

    PubMed Google Scholar

25. Wang, J., Xu, H., Zhou, S., Wang, D., Zhu, L., Hou, J. et al. Body mass index and mortality in lung cancer patients: a systematic review and meta-analysis. Eur. J. Clin. Nutr. 72, 4–17 (2018).

    CAS PubMed Google Scholar

26. Arem, H. & Irwin, L. Obesity and endometrial cancer survival:a systematic review. Int J. Obes. 37, 634–639 (2013).

    CAS Google Scholar

27. Christensen, J. F., Simonsen, C. & Hojman, P. Exercise training in cancer control and treatment. Comprehensive Physiol. 9, 165–205 (2019).

28. Playdon, M. C., Bracken, M. B., Sanft, T. B., Ligibel, J. A., Harrigan, M. & Irwin, M. L. Weight gain after breast cancer diagnosis and all-cause mortality: systematic review and meta-analysis. J. Natl Cancer Inst. 107, djv275 (2015).

    PubMed PubMed Central Google Scholar

29. Otto, S. J., Korfa*ge, I. J., Polinder, S., van der Heide, A., de Cries, E., Rietjens, J. A. C. et al. Association of change in physical activity and body weight with quality of life and mortality in colorectal cancer: a systematic review and meta-analysis. Support Care Cancer 23, 1237–1250 (2015).

    CAS PubMed Google Scholar

30. Doleman, B., Mills, K., Lim, 3, Zelhart, M. & Gagliardi, G. Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Tech. Coloproctol. 20, 517–535 (2016).

    CAS PubMed Google Scholar

31. Caan, B. J., Cespedes Feliciano, E. M. & Kroenke, C. H. The importance of body composition in explaining the overweight paradox in cancer-counterpoint. Cancer Res. 78, 1906–1912 (2018).

    CAS PubMed PubMed Central Google Scholar

32. Parkin, E. & Renehan, A. G. Need to distinguish the term sarcopenia from risk stratification derived from muscle parameters. J. Clin. Oncol. 36, 2128–2129 (2018).

    PubMed Google Scholar

33. Baracos, V. E. & Arribas, L. Sarcopenic obesity: hidden muscle wasting and its impact for survival and complications of cancer therapy. Ann. Oncol. 29, ii1–ii9 (2018).

    CAS PubMed Google Scholar

34. Caan, B. J., Cespededs Feliciano, E. M., Prado, C. M., Alexeeff, S., Kroenke, C. H., Bradshaw, P. et al. Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol. 4, 798–804 (2018).

    PubMed PubMed Central Google Scholar

35. Slawinski, C. G. V., Barriuso, J., Guo, H. & Renehan, A. G. 2020 obesity and cancer treatment outcomes: interpreting the complex evidence clinical oncology. Clin. Oncol. 32, 591–608 (2020).

    CAS Google Scholar

36. Parekh, N., Chandran, U. & Bandera, E. V. Obesity in cancer survival. Annu. Rev. Nutr. 32, 311–342 (2012).

    CAS PubMed Google Scholar

37. Protani, M., Coory, M. & Martin, J. H. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res. Treat. 123, 627–635 (2010).

    PubMed Google Scholar

38. Doerstling, S. S., O’Flanagan, C. H. & Hursting, S. D. Obesity and cancer metabolism: a perspective on interacting tumor–intrinsic and extrinsic factors. Front. Oncol. 7, 216 (2017).

    PubMed PubMed Central Google Scholar

39. Doleman, B., Mills, K. T., Lim, S., Zelhart, M. D. & Gagliardi, G. Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Tech. Coloproctol. 20, 517–535 (2016).

    CAS PubMed Google Scholar

40. Chlebowski, R. T., Blackburn, G. L., Thomson, C. A., Nixon, D. W., Shapiro, A., Hoy, M. K. et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J. Natl Cancer Inst. 98, 1767–1776 (2006).

    PubMed Google Scholar

41. Rock, C. L., Pande, C., Flatt, S. W., Ying, C., Pakiz, B., Parker, B. A. et al. Favorable changes in serum estrogens and other biologic factors after weight loss in breast cancer survivors who are overweight or obese. Clin. Breast Cancer 13, 188–195 (2013).

42. Harrigan, M., Cartmel, B., Loftfield, E., Sanft, T., Chagpar, A. B., Zhou, Y. et al. Randomized trial comparing telephone versus in-person weight loss counseling on body composition and circulating biomarkers in women treated for breast cancer: the lifestyle, exercise, and nutrition (LEAN) study. J. Clin. Oncol. 34, 669–676 (2016).

    PubMed Google Scholar

43. Pakiz, B., Flatt, S. W., Bardwell, W. A., Rock, C. L. & Mills, P. J. Effects of a weight loss intervention on body mass, fitness, and inflammatory biomarkers in overweight or obese breast cancer survivors. Int. J. Behav. Med. 18, 333–341 (2011).

    PubMed PubMed Central Google Scholar

44. Ligibel, J. A., Barry, W. T., Alfano, C. M., Hershman, D. L., Irwin, M. L., Neuhouser, M. et al. The breast cancer weight loss (BWEL) trial: randomized phase III trial evaluating the role of weight loss in adjuvant treatment of overweight and obese women with early-stage breast cancer (Alliance A011401). J. Clin. Oncol. 36, TPS598–TPS598 (2018).

    Google Scholar

45. Rack, B., Andergassen, U., Neugebauer, J., Salmen, J., Hepp, P., Sommer, H. et al. The German SUCCESS C Study—the first european lifestyle study on breast cancer. Breast Care 5, 395–400 (2010).

    PubMed PubMed Central Google Scholar

46. Villarini, A., Pasanisi, P., Traina, A., Mano, M. P., Bonanni, B., Panico, S. et al. Lifestyle and breast cancer recurrences: the DIANA-5 trial. Tumori 98, 1–18 (2012).

    CAS PubMed Google Scholar

47. Kitson, S., Ryan, N., MacKintosh, M. L., Edmondson, R., Duffy, J. M. & Crosbie, E. J. Interventions for weight reduction in obesity to improve survival in women with endometrial cancer. Cochrane Database Syst. Rev. 2, CD012513, https://doi.org/10.1002/14651858.CD012513.pub2 (2018).

    Article PubMed Google Scholar

48. Jackson, S. E., Heinrich, M., Beeken, R. J. & Wardle, J. Weight loss and mortality in overweight and obese cancer survivors: a systematic review. PloS ONE 12, e0169173 (2017).

    PubMed PubMed Central Google Scholar

49. Demark-Wahnefried, W., Schmitz, K. H., Alfano, C. M., Bail, J. R., Goodwin, P. J., Thomson, C. A. et al. Weight management and physical activity throughout the cancer care continuum. CA Cancer J. Clin. 68, 64–89 (2018).

    PubMed Google Scholar

50. Renehan, A. G., Alam, N. N. & Sperrin, M. Interaction between co-morbidities and cancer survival. Eur. J. Epidemiol. 34, 1103–1105 (2019).

    CAS PubMed Google Scholar

51. Martin, L. P., Senesse, I., Gioulbasanis, I., Antoun, S., Bozzetti, F., Deans, C. et al. Diagnostic criteria for the classification of cancer-associated weight loss. J. Clin. Oncol. 33, 90–99 (2015).

    PubMed Google Scholar

52. Vance, V., Mourtzakis, M., McCargar, L. & Hanning, R. Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes. Rev. 12, 282–294 (2011).

    CAS PubMed Google Scholar

53. Makari-Judson, G., Braun, B., Jerry, D. J. & Mertens, W. C. Weight gain following breast cancer diagnosis: implication and proposed mechanisms. World J. Clin. Oncol. 5, 272–282 (2014).

    PubMed PubMed Central Google Scholar

54. Gandhi, A., Copson, E., Eccles, D., Durcan, L., Howell, A., Morris, J. et al. Predictors of weight gain in a cohort of premenopausal early breast cancer patients receiving chemotherapy. Breast 45, 1–6 (2019).

    PubMed Google Scholar

55. Sepulveda, A. R., Hamilton, S. R., Allegra, C. J., Grody, W., Cushman-Vokoun, A. M., Funkhouser, W. K. et al. Molecular biomarkers for the evaluation of colorectal cancer: guideline from the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and the American Society of Clinical Oncology. J. Clin. Oncol. 35, 1453–1486 (2017).

    CAS PubMed Google Scholar

56. Williamson, P. R., Altman, D. G., Bagley, H., Barnes, K. L., Blazeby, J. M., Brookes, S. T. et al. The COMET handbook: version 1.0. Trials 18, 280 (2017).

    PubMed PubMed Central Google Scholar

57. Rosenbaum, M., Agurs-Collins, T., Bray, M. S., Hall, K. D., Hopkins, M., Laughlin, M. et al. Accumulating data to optimally predict obesity treatment (ADOPT): recommendations from the biological domain. Obesity 26, S25–S34 (2018).

    PubMed Google Scholar

58. Ballard-Barbash, R., Hunsberger, S., Alciati, M. H., Blair, S. N., Godwin, P. J., McTiernan, A. et al. Physical activity, weight control, and breast cancer risk and survival: clinical trial rationale and design considerations. J. Natl Cancer Inst. 101, 630–643 (2009).

    PubMed PubMed Central Google Scholar

59. Chaput, J. P., Klingenberg, L., Rosenkilde, M., Gilbert, J. A., Tremblay, A. & Sjödin, A. Physical activity plays an important role in body weight regulation. J. Obes. pii: 360257. https://doi.org/10.1155/2011/360257 (2011).

60. Ostendorf, D. M., Caldwell, A. E., Creasy, S. A., Pan, Z., Lyden, K., Bergouignan, A. et al. Physical activity energy expenditure and total daily energy expenditure in successful weight loss maintainers. Obesity 27, 496–504 (2019).

    PubMed Google Scholar

61. Poggiogalle, E., Migliaccio, S., Lenzi, A. & Donini, L. M. Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity. Endocrine 47, 699–716 (2014).

    CAS PubMed Google Scholar

62. Caan, B. J., Cespedes Feliciano, E. M., Prado, C. M., Alexeeff, S., Kroenke, C. H., Bradhsaw, P. et al. Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol. 4, 798–804 (2018).

    PubMed PubMed Central Google Scholar

63. Stiegler, P. & Cunliffe, A. The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports Med. 36, 239–262 (2006).

    PubMed Google Scholar

64. Friedenreich, C. M., Stone, C. R., Cheung, W. Y., Hayes, S. C. Physical activity and mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectr. 4, pkz080 (2019).

65. Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S. et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med. Sci. Sports Exerc 51, 2375–2390 (2019).

    PubMed PubMed Central Google Scholar

66. Harvie, M., Wright, C., Pegington, M., McMullan, D., Mitchell, E., Martin, B., Cutler, R. G. et al. The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Br. J. Nutr. 110, 1534–1547 (2013).

    CAS PubMed PubMed Central Google Scholar

67. Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L. et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 391, 541–551 (2018).

    PubMed Google Scholar

68. Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A. et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393–403 (2002).

    CAS PubMed Google Scholar

69. Hoedjes, M., van Stralen, M. M., Joe, S. T. A., Rookus, M., van Leeuwen, F., Michie, S. et al. Toward the optimal strategy for sustained weight loss in overweight cancer survivors: a systematic review of the literature. J. Cancer Surviv. 11, 360–385 (2017).

    PubMed PubMed Central Google Scholar

70. Sandu, M. R., Beynon, R., Richmond, R., Ferreira, S. L. S., Hackshaw-McGeagh, L., Smith, G. D. et al. Two-step randomisation: applying the results of small feasibility studies of interventions to large-scale Mendelian randomisation studies to robustly infer causal effects on clinical endpoints. Preprint at https://doi.org/10.20944/preprints201910.0276.v1 (2019).

71. Beynon, R., Richmond, R. C., Santos Ferreira, D. L., Ness, A. R., May, M., Davey, G. D. et al. The ProtecT Study Group. The PRACTICAL consortium. Investigating the effects of lycopene and green tea on the metabolome of men at risk of prostate cancer: the ProDiet randomised controlled trial. Int. J. Cancer https://doi.org/10.1002/ijc.31929 (2018).

    Article PubMed PubMed Central Google Scholar

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