- Question from Carol: I was diagnosed with breast cancer on June 16, 2002 and I was wondering why I can feel so good, and then have a couple of days that put me down. Shouldn't I be over that by now? Also, even though I bike ride almost every day, I still need to lose weight. But I'm on tamoxifen and some women say it's hard to lose weight while you are on tamoxifen. I have also started taking coral calcium. Do you know anything about that?
Anne McTiernan, M.D., Ph.D.
While many people think tamoxifen is associated with weight gain, we've found in our studies of over 1,000 breast cancer patients that women who are using tamoxifen are actually less overweight than women who are not using tamoxifen. I think one of the reasons women gain weight after a breast cancer diagnosis is that they change their exercise and eating habits. Often, they reduce the amount of activity that they do and they become more likely to eat 'comfort food' rather than healthful food. In combination, those two things can result in weight gain. But it's never too late to reverse this pattern.
We're finding that breast cancer patients do very well with a weight loss program that combines healthy eating and increased activity. This doesn't mean you need to feel hungry. We find that many women are not fully aware of what they're eating; they're not aware of their calorie intake and they don't really know how much fat they're consuming. Once they become aware, it's easier to make the right food choices and lose weight.
Marisa Weiss, M.D.
Many of you may have gained weight during chemotherapy because of the comfort eating Dr. McTiernan just mentioned, and also because of medications, such as steroids, that you may have been given to ease side effects. You may also be on long-term medications that are associated with weight gain; some antidepressants, for example. But as Dr. McTiernan said, as difficult as this problem can be, a careful plan of exercise and dietary changes can enable many women to make progress in this area. The fact that most foods now have labeling can help you know what's in the food you eat. This can help you can make modifications in your diet.
Regarding the calcium, there are many different sources of calcium. They all work, but remember that your body can only absorb a limited amount of calcium at a time. Generally, you should take 500mg three times a day. Some preparations involve taking 600mg twice a day. I wouldn't go higher than that for any one dose. Take into consideration how much calcium you are taking in through your diet as well.
- Anne McTiernan, M.D., Ph.D. Most experts recommend about 1200-1500mg of calcium per day, and for many women the best way to get it is through food. A glass of milk has about 300mg of calcium, and there are many places on the web where you can get information about the calcium content of various foods. But if you can't eat dairy foods or don't like them, taking calcium supplements is the best alternative.
The Ask-the-Expert Online Conference called Taking Care of Yourself featured Anne McTiernan, M.D., Ph.D. and Marisa Weiss, M.D. answering your questions about exercise and nutrition, and other things you can do to nurture your body, along with strategies for finding emotional support, boosting your mood, and feeling good again.
Editor's Note: This conference took place in May 2003.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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