Cancer Survivors Confront Weight Gain Together

Karen Cherelstein had a normal mammogram in October 2006, but a self-examination in January 2007 revealed a lump. A visit to her OB-GYN and a biopsy confirmed her fears: she had Stage 1 cancer with a small tumor just before her fiftieth birthday. “When my internist asked for a special appointment, I knew the news wouldn’t be good,” Ms. Cherelstein says. “As more results came through, I learned that my cancer was aggressive.” She spent several months undergoing chemotherapy and radiation under the guidance of Gary Cohen, MD, Medical Director of the Sandra & Malcolm Berman Cancer Institute at GBMC, and has been cancer-free for eight years.

“By October 2007, I was working full-time again and my hair was growing back,” Ms. Cherelstein says, “but I was beginning to have weight issues.” At 5 feet 1 inch tall, she says that any additional weight is obvious on her body. Not realizing it might be related to her cancer, she struggled with managing her weight for years and, by October 2014, she had reached a number on the scale that she could not believe.

"Studies have shown that excess body weight may be linked to certain cancers, including breast cancer."

While Ms. Cherelstein fought to achieve a healthy weight, her friend Diane McClyment was going through similar life and body changes. Ms. McClyment was called back after a mammogram in October 2013 and a biopsy revealed she had breast cancer. Her physicians at a local hospital recommended radical treatments, which had her on edge. Ms. Cherelstein suggested a second opinion with Dr. Cohen. “The minute I met him, I knew he was the right doctor for me,” Ms. McClyment Friends and cancer survivors Karen Cherelstein (left, in pink) and Diane McClyment often exercise together to encourage each other and hold each other accountable. www.gbmc.org | GREATER living 5 says. “He handled everything, even contacted a physician I had 25 years ago in New York to discuss my previous lymphoma treatment.”

With Dr. Cohen overseeing her care, Lauren Schnaper, MD, performing her surgery and Geoffrey Neuner, MD, administering radiation therapy, Ms. McClyment felt she was in great hands. She had a lumpectomy and was treated with a “one and done” radiation treatment, both of which were successful. “My only complaint was the weight gain. Like Karen, I was grateful to be alive, but had a difficult time shedding excess pounds.”

At a September 2014 follow-up appointment, Dr. Cohen could tell Ms. McClyment felt negatively about her appearance. “Studies have shown that excess body weight may be linked to certain cancers, including breast cancer,” says Dr. Cohen. “Excess weight and obesity may lead to worse outcomes despite cancer treatments, and weight gain following a breast cancer diagnosis may significantly increase the risk of recurrence and cancer-related deaths.” Dr. Cohen referred Ms. McClyment to a clinical trial entitled “A Randomized Study Evaluating the Effect of a Remote-Based Weight Loss Program on Biomarkers in Women with Early Stage Breast Cancer” being offered through the Johns Hopkins Clinical Research Network (JHCRN). The JHCRN is a collaborative effort between GBMC, the Johns Hopkins Institute for Clinical and Translational Research and several other regional medical centers. It is designed to accelerate the transfer of new diagnostic, treatment and disease prevention advances from research to direct patient care. Ms. McClyment was excited about the weight control study and immediately enrolled.

“The trial is a yearlong weight loss program designed to specifically meet the unique needs of women who have completed their acute therapy for early breast cancer,” says Vered Stearns, MD, Co-Director of the Johns Hopkins Breast and Ovarian Cancer Program and a lead physician on the JHCRN research team. Study participants are randomized into two groups, self-directed weight loss or active remote intervention (Practice-based Opportunities for Weight Reduction, or POWER-remote), and each group follows a strict plan of exercise, diet tracking and health assessments. The goal of the study is to gauge the effectiveness of weight loss intervention techniques and assess the effects of weight loss on biomarkers associated with breast cancer, inflammation and obesity. This information will be used to help implement further clinical intervention techniques in breast cancer patients.
“While it is too early to determine overall benefits, we have seen an increase in awareness and attention to diet and physical activity in all participants, and several women have experienced a reduction in their weight,” says Dr. Stearns.

Ms. McClyment was placed in the active intervention POWER-remote group and has lost 37 pounds and four inches from her waist, is down four sizes and is pleased with the reasonable goals and accountability aspects of the program. Ms. Cherelstein, who could not directly take part in the study because of the time elapsed since her treatment, completed the program on her own by sharing Ms. McClyment’s study plan. Both women are thrilled with the marked improvement in their individual bodies, minds and overall health. “We started checking in with each other almost every day as the pounds started rolling off,” Ms. Cherelstein says. “It was a process, but we’ve both excelled. We talk about shopping for new clothes instead of how fat we feel! We’re grateful for the care we received and are optimistic that the odds of cancer recurrence have been decreased for both of us.”