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The Weight Battle:

Dietitians offer strategies for controlling weight after cancer treatment

Michelle Churches walks 11,000 steps during her 10-hour nursing shift at an outpatient surgery center in Trenton.

She knows this because she wears a pedometer. After walking those 11,000 steps, she comes home and pulls together a homemade dinner in about 30 minutes. She chats with her husband and kids, cleans up the kitchen and heads out to walk the dog. Some weeks, depending on her work schedule, she'll fit in an extra 12-hour shift to help fund a gift she wants to give her three children: a debtfree ride through college.

To say that Churches is active would draw an affectionate chuckle from her friends. When the season is right, Churches has been known to work from dawn to dusk in her herb garden, stopping only long enough for occasional water breaks. So when she was diagnosed in 2005 with breast cancer, weight wasn't a concern for her. She was 5 feet 7 inches and 138 pounds. But after a mastectomy, chemotherapy, radiation and hormone therapy, Churches has found it's more difficult to maintain her weight.

"I work my butt off so that now when I look at a Reese's Peanut Butter Cup, I have a little calculator in my head: How much will it take to burn this off? Is it worth it?" she says.

At the University of Michigan Comprehensive Cancer Center, dietitians Joan Daniels and Nancy Burke spend a lot of time helping people prevent weight loss during treatment. But they also see patients who struggle to lose weight after cancer treatment. This is particularly true of breast and prostate cancer patients who receive hormone therapy. Certain chemotherapy regimens also may cause patients to lose muscle and gain fat tissue.

It may be more difficult to lose weight, but Daniels and Burke stress that it's still important to try to control what you can: diet and exercise.

"The bottom line is that you can manage your weight, but it takes a lot more effort," Daniels said. "You have to exercise more and you have to cut back your food more."

Depression may also be an underlying factor that needs to be addressed, Daniels said. Sometimes the full psychological impact of cancer doesn't hit until a patient is into post-treatment survivorship. This can interfere with exercise regimens or cause people to binge.

Exercise can help reduce depression and anxiety as well as lower the risk of recurrence. One strategy Burke recommends for patients seeking to lose weight is to find an activity they enjoy to boost their commitment to exercising. For Churches, gardening is a great workout and also keeps her kitchen stocked during part of the year with healthy fruits, vegetables and herbs. Late last fall, as the season was ending, Churches was preparing to dry herbs to season foods during the winter months.

Churches uses herbs as a way to boost flavors without adding fat. Staying organized also makes eating healthier easier: Churches stocks the pantry with good choices so healthy snacks are always within reach. S he prepares meals ahead of time so that there's very little work to do to get the meal on the table after work. The Churcheses limit take-out to Wednesday nights when they splurge on a pizza or Mexican food.

"All the women in my family cook like this. My mom always said, 'Fast food is nothing but poison,'" Churches said, pausing to admit her guilty pleasure: Diet Coke. "My mom always had stuff she could throw together simply, and I do, too. I practice what I preach."

Print Michelle Churches's Chenin Blanc Chicken recipe [PDF].

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This article first appeared in the Winter, 2011 issue of Thrive.
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