ASCO: Oncologists Must Integrate Obesity Education, Management Into Cancer Care

In its first policy statement on the relationship between cancer and obesity, the American Society of Clinical Oncology (ASCO) called on oncologists to help educate the public about the risks of obesity and integrate obesity prevention and management into the care of their patients.

In the paper published October 1 in the Journal of Clinical Oncology, ASCO said it is working to provide clinical guidelines, tools, and resources to help oncologists initiate conversations with patients and support their weight-loss efforts. For example, the group recently introduced an online guide for providers with information on clinical practice guidelines and strategies to promote weight management.

Acknowledging that oncologists have not traditionally been involved in weight management issues, the authors noted that relevant courses should be integrated into medical school and fellowship programs. For now, oncologists should develop basic skills in talking to cancer patients and survivors about calculating body mass index and assessing weight status, and the role of healthy eating and exercise on reducing fatigue, improving body image, and lowering incidence of comorbidity.

Many studies suggest that obesity at cancer diagnosis may be linked to increased recurrence and mortality, the authors noted. Obesity can also interfere with the effective delivery of cancer therapy and increase the risks for developing second primary malignancies and comorbidities, such as cardiovascular disease and diabetes.

In order to promote long-term behavior change, it’s important for oncologists to partner with other members of the cancer care team, including advanced-practice providers, primary care physicians, and other professionals, such as dietitians and physical therapists, the authors said. Oncologists should also attempt to model and promote healthy lifestyles in the community.

“Sharing personal experiences regarding attempts at weight loss or increased physical activity can be a powerful motivating factor for patients and family members,” the authors wrote. “Taking part in community events focused on physical activity or other elements of healthy living … can also reinforce the importance of healthy lifestyle behaviors as part of a comprehensive cancer-control strategy.”

Besides providing clinical guidance and tools for physicians, ASCO recommended strategies for increasing public education, research, and public policy around cancer and obesity. For example, advocacy should focus on improving access to nutrition and exercise counseling services for cancer patients and promoting insurance coverage for and access to obesity screening, diagnosis and treatment services.

Although obesity is quickly overtaking tobacco as the leading preventable cause of cancer, public awareness of the relationship between obesity and cancer is limited, as is definitive data from randomized trials, the authors said.

“There are few national resources to help patients with cancer lead healthier lives after a cancer diagnosis,” the authors wrote. “Significant efforts are needed to educate providers and patients regarding the links between obesity and cancer, to help investigators evaluate the impact of weight loss on cancer risk and outcomes, and to develop and disseminate effective strategies to help patients with cancer initiate and maintain healthy lifestyle changes after a cancer diagnosis.”