#50 Metabolic Syndrome and Breast Cancer Treatment

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Metabolic syndrome is a cluster of symptoms that raise a red flag telling you something is going wrong with the management of your blood sugar and your resistance to insulin.

If you have metabolic syndrome, you're at a higher risk of developing breast cancer. However, if you have had treatment for breast cancer, you are at a higher risk of developing metabolic syndrome.

A recent study even indicates that chemotherapy is a direct cause of metabolic syndrome in women being treated for breast cancer.

In this show you'l learn what the symptoms of metabolic syndrome are, why its important for you to recognize them, what they can lead to if left untreated and valuable, simple action steps you can take to manage, prevent and potentially reverse the symptoms of metabolic syndrome.

Arming yourself with knowledge is the best way to get power over what's happening in your body after breast cancer treatment. Informing yourself helps you to ask your doctors the right questions and to build lifestyle routines that support your well-being rather than undermine it. Listen into this powerful episode and understand more about the struggle to manage weight and restore your health after breast cancer treatment.

Resources for this episode: Books:

      
Tools:

Studies and Articles:

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

Is There a Connection Between Diabetes and Breast Cancer?

What is the relationship between breast cancer and diabetes?

Read Full Transcript Below:

Hello and welcome..episode 50!

Metabolic syndrome and breast cancer...I’m Laura Lummer

Before we get started remind about revivify changing... 

Share a story 

Last week I'm sitting in the nail salon getting my nails done and about 5 feet away from me is a woman getting a pedicure in one of the spa chairs, there’s and empty spot next to her which is filled by another woman after a few minutes. When the second woman sits down, the first woman starts to have a little bit of a coughing fit second woman offered her cough drop And they got to chatting, which I can’t help but overhear because of where I’m sitting.

The second woman proceeds to ask the first woman if she’s getting her nails done to do something fun, and the first woman responds with “oh no I have four children so there's no time for me, I have to take care of everyone else.

 Then I just about had a coughing fit right there, trying to swallow my tongue. 

She went on to talk about how two of the four children were adults and living on their own but she still had so much to do anyway. 

Okay you know how I feel about treating yourself well and making yourself a priority. And by that, I mean making time to take what you need for your well-being, your healing, and just basically figuring your s*** out. 

You can't get in touch with that voice, that source, that feeling that gives you Direction in life without some down time. You simply cannot do it!

If you have small children I know that's difficult, I raised four children and for several of those years I did that as a single parent working full-time. 

But I also know you must find a way to make self care doable because in order to have the energy to take care of those kids and work the very demanding job you have to make sure you are exercising regularly and preparing good food...for everybody. 

Will there be lapses in your routine?... of course, but it's not about living a perfect life. it's about doing the best you can with a focus on eating well and exercising regularly most of the time. It’s about making your health a priority.

And if you have small children trust me one of the best things you can do is teach them how to exercise with you. Make a point of playing frisbee at the park or in the backyard.  There are all kinds of fun 5 K's Like color runs and the bubble runs and glow in the dark run that kids can participate in with you and part of the responsibility of parenting is teaching our little humans how to properly nourish and care for their bodies right? 

Bottom line...

It is time in this world, in this universe, in your life, for women everywhere to understand their value. I especially mean that for women who are struggling with or recovering from cancer treatment. 

Working yourself to death and never caring for yourself is not a badge of honor my friend. Taking care of yourself, owning your value, setting healthy boundaries, and making the time to take good care of yourself...those are Badges of Honor. Those are the things that the loved ones around you will see and be inspired by. 

 No one ever said I cannot wait to be a martyr just like my mom. No one... Ever! So set the example that your loved ones will aspire to follow.

And this is a perfect segue into this week's topic which is metabolic syndrome and cancer treatment. We’ll talk about what metabolic syndrome is as well as the connection between diabetes and breast cancer. 

I’ll give you some insights on what the causes can be and some steps you can take to work toward preventing or reversing metabolic syndrome. 

First let me Define metabolic syndrome and why you should be paying attention to it and then I’ll tell you how it relates to breast cancer and breast cancer treatment. 

Metabolic syndrome is a collection of five Symptoms. If you have three of these five you are considered to have metabolic syndrome. They are: 

  • high blood pressure 130-139/80-89
  • high fasting blood sugar >100Mg/DL
  • large waistline 32” or more for women
  • high triglyceride levels >150mg/dl
  • low HDL cholesterol levels ,40mg/dl

Metabolic syndrome is a bit of a double-edged sword because studies show that if you already have metabolic syndrome you are at a higher risk of developing breast cancer and on the flipside if you've been treated for breast cancer with chemotherapy you have a higher risk of developing metabolic syndrome and diabetes. We’ll get more into that in a minute

Now it’s important to distinguish two things here.
1- Metabolic syndrome is not a disease. It is a collection of risk factors that indicate your risk of disease...that disease being type two diabetes.

2- It is also not prediabetes
The American Diabetes Association (ADA) defines pre-diabetes as a hemoglobin A1C ranging from 5.7% to 6.4%, a fasting glucose ranging from 100 mg/dL to 125 mg/dL and an oral glucose tolerance ranging from 140 mg/dL to 199 mg/dL.2

Hemoglobin A1c is a measurement of your average blood sugar over the past two to three months. It looks at the amount of sugar stuck to the hemoglobin in your red blood cells. So the higher your blood sugar is, the more glucose, or blood sugar will stick to this protein in your blood cells. Because rbc live about 120 days, they’re around long enough to accumulate a lot of glucose if you have a situation going on.

A high HbA1c test can be a warning sign that you need to start taking some action to get your blood sugar in check.

So what does this have to do with breast cancer treatment?

If you heard episode 45, I referred to a study by women’s college hospital, women’s research institute that included over 140,000 cancer survivors and non cancer survivors. Out of all the women in the study, nearly 10% of them developed diabetes within 6 years from the start of the research.

However, the risk for the breast cancer survivors in the study was  7 percent higher than the women who hadn’t had cancer. And of those survivors the ones who had chemotherapy as a part of their treatment, had a 24% higher risk of developing diabetes within 2 years after diagnosis compared with women who had not had breast cancer.

After 10 years, the 7 percent increased risk for all the breast cancer survivors grew to 21%

So, what is going on here and what does this have to do with metabolic syndrome. Well, diabetes is a disease that is rooted in insulin resistance. And Metabolic syndrome is a cluster of symptoms that can be a warning sign that you are developing insulin resistance. If those indicators escalate into prediabetes and if not addressed can escalate into full blown diabetes.

The American Diabetes Association says that  their obese, inactive, patients with high blood pressure slowly develop insulin resistance, and that often develops into pre-diabetes.

I find the word obesity to be a little deceptive. When I hear that word I think of someone who is severely overweight, because that’s the word that was used when I was a kid and someone was 100 or more  pounds overweight.


But the criteria for obese is simply a BMI of 30 or more. I’ll post a link to a BMI calculator in the show notes for this episode, but to put it simply your BMI is calculation of your weight in kilograms divided by your height in meters squared.

So, depending on how tall you are, you don’t have to be that much overweight to fall into the obesity category.

This is important because when you’re dealing with metabolic syndrome and potential insulin resistance. If you have consistently high blood sugar, you're not only going to struggle even more than normal to lose weight, but you are at a higher risk for breast cancer. Remember that double edge sword I mentioned in the beginning of the show?

So, what if you are listening to this and thinking you have a healthy diet and you lead an active life, without sodas and sugary processed foods and this doesn’t make sense to you...why would you have insulin resistance or metabolic syndrome or such a hard time losing weight...hang in there with me girl. We’re going to look at some other evidence.

A small study published in the journal Cancer In sept, 2016 looked at 86 women diagnosed with stage 1-stage 3 breast cancer. Some women were premenopausal and some were post, there were 5 different types of chemotherapy treatments administered between all of the subjects.

The five symptoms of metabolic syndrome were measured before and after these women had chemotherapy treatment and it was determined they had no metabolic syndrome before treatment. After 12-18 weeks of chemotherapy more than 72% of the women were diagnosed with metabolic syndrome.

Not only were the symptoms worse for these women but they were considered to be  statistically significant, which in science talk means the change was likely due to the chemotherapy. And it didn’t matter if they were pre or post menopausal when their treatment started.

Two of the most staggering statistics from the study were that fasting insulin increased by nearly 73% and HOMA‐IR, (a measurement of insulin resistance) increased by almost 108% over the course of the study which was only 4 months.

If you’re interested in reading the study, I’ll post a link to it in the show notes page for this episode. Lauralummer.com/50

Now, I don’t give you this information to discourage you. I give it to you so you don’t feel like you’re alone or that you’ve done something wrong.

 I cannot tell you how many medical professionals told me that weight gain was not related to breast cancer treatment and how frustrated I have been over the years when my search for help has fallen on deaf ears.

So I want you to know, this shit is for real and I hear you.
Now before I start talking about what you can do about metabolic syndrome I want to just mention 2 things.

1- After breast cancer treatment, there’s a lot of tough adjustments you have to make, and trauma that you have to come to terms with. It is not unusual for me to hear from my ladies in recovery that they turn to emotional eating to deal with this often very difficult experience and transition. If you find yourself here. Please reach out for support,  because just as food can be medicine, food can be destructive, and when you’re consuming food that may be lending to inflammation, weight gain and disease and you’re telling yourself you deserve it, or you’ve earned it, I would challenge you to practice some mindful eating techniques. Because I think you’ll realize that you’re really not helping yourself at all and in fact your making yourself feel worse.
I understand the thought process but I don’t want you to feel worse.

#2- In the study of the 89 women I just told you about, initially 963 women were screened to be participants but only 153 me the initial eligibility requirements which was to not have preexisting metabolic syndrome. The reason this is frightening is because if you go into breast cancer with metabolic syndrome, you have a higher chance of poor outcomes from treatment.
So we need to take some steps to get healthy ladies. This is not about being skinny but being healthy and living the longest, happiest, most fulfilling life possible.

So what are some steps you can take. To prevent or to reverse metabolic syndrome.

You know I’m a big fan of mindful eating and food preparation. No joke food preparation will change your life. But, I’m also a huge fan of scientific data because its fascinating.

So, this may be a little much for you so, give me a minute to frame this properly.
You know how I encourage you to buy vegan and vegetarian cookbooks so you can expand your choices of plant based dishes. Yet, I inevitably hear, but I don't want to be a vegetarian, or I like meat.

I get that, I’m not asking anyone to be a vegetarian or a vegan, (i’m not even a vegetarian or a vegan) I just want you to learn about ways to make yummy plant based dishes and if you want to serve those up next to a big ole steak.. Go for it. But try to keep your mind open to new ways of preparing foods.

In that same vein of thinking, if you don’t have diabetes but you are struggling with weight or you meet the criteria for metabolic syndrome, you can pick up books, magazines or scroll the internet for recipes used for diabetes. If these foods help someone who has the full blown disease, certainly they will help you to keep from getting it.
Make sense?

The key here is to control blood sugar, and in doing that you may very well lose weight. Thanks to technology, you also don’t have to wait until your next dr appt to get some really good insights here. 

One thing that I have been doing in using a glucose meter that I picked up at CVS and taking my own blood sugar throughout the day.
I take it when I wake up, before I go to bed and before and after my meals so that I can truly see how my body is responding to different foods and what the cycles of my blood sugar are throughout the day. No guessing involved.
So let me share some insights on what I’ve discovered.

1- When I go long periods without food, my blood sugar goes up...yeah, my liver is a blood sugar making machine! So I know I need to eat small frequent meals to prevent my blood sugar from having spikes.

And this is all within expected blood sugar ranges but I want to keep it that way.

2- If I eat a carbohydrate by itself, and that is a good whole grain carbohydrates, like sprouted bread, my blood sugar goes way up and it stays up for several hours.

3-vodka and red wine don’t elevate my blood sugar-hallelujah!

Seriously though, if pricking your finger throughout the day is overwhelming for you it certainly isn’t necessary, just try to pay attention to how your body responds after eating different foods. Creating this awareness and learning about the foods and  the ways of eating that control blood sugar will get you on the right path.

As a breast cancer survivor and as a person who wants to have healthy blood sugar levels you must exercise… I know I know you don’t want to hear It but you have to hear it girl. You need to get in 30 minutes of moving enough to break a sweat 5-7 times a week. This will increase your sensitivity to insulin and support healthy blood sugar. Exercise is medicine and any exercise is better than no exercise. Try to start off with the mindset of just sitting less. Try checking out the groupons in your local area. I’m amazed at the deals you can get on fitness centers from groupon. I recently got one month unlimited spin classes for $9! That was a 90% discount!

The great thing about this approach is that you can try lots of different workouts until you find the type of exercise and the group of people that you really enjoy. The truth is that is what will keep you coming back. We do the things we like. So have some fun with this

There can certainly be other factors at play here and of course you want to work with your dr to be sure your thyroid, or a vitamin deficiency or a kidney issue are not causing problems for you.

There are several chemotherapy drugs that can harm the kidneys including

Chemotherapy drugs that are known to be nephrotoxic include:
-Cisplatin
-carboplatin (Paraplatin, Paraplatin AQ)
-ifosfamide (Ifex)
-Methotrexate

I’m sure your oncologist was or is keeping an eye on that for you but it doesn’t hurt to have everything checked out or at least to ask questions.

Because blood sugar and diabetes are such serious issues there are also medications that can support you .

 In episode 47 I talked about an herb that is often used to support healthy blood sugar, called gymnema sylvestre and a commonly used pharmaceutical metformin is also an option.

In the  february 2018 article, Is There a Connection Between Diabetes and Breast Cancer? Published in usnews Dr. Sagar Sardesai, assistant professor of medicine at the Stefanie Spielman Comprehensive Breast Center at The Ohio State University Wexner Medical Center. Said, "Women who were diabetic and taking metformin had a 25 percent lesser risk of developing breast cancer," than nondiabetic women who weren't taking the drug and that even though it isn’t understood why at this point that.. it could be controlling blood sugars reduces risk for developing breast cancer, he goes on to say "metformin is being actively investigated in reducing cancer risk.”

So let’s recap:
Now you know what metabolic syndrome is and what it can lead to.
You know that in addition to diet, chemotherapy, stage of life, genetics, and inactivity can contribute to metabolic syndrome.
If you don’t take steps to manage your blood sugar when you have this cluster of symptoms it can escalate into more serious stages including type 2 diabetes.
Steps you can take include:

Educating yourself on recipes and foods used to manage diabetes
Seeking support with the emotional triggers that lead you to eating foods that undermine weight and blood sugar management.

I mean we all know it not about the food right? You know what good food is. It’s about the behaviors and the habits we have developed. So mindful eating is a useful tool to help you develop awareness around what you’re eating, why you’re eating it, and how it really makes you feel.

You can use a simple tool that you can pick up at any drugstore to watch how your blood sugar reacts to different foods and how your body responds throughout the day. I’ll put a link to the monitor I use in the show notes. I like this one because if you’re following a ketogenic diet, it also measures ketones.

You also know that exercise is a critical component to managing blood sugar and you have a fun and budget friendly strategy.

You also know that there are herbs and medications that you can discuss with your doctor to support you. Let's talk for just a minute about this too. I’m one of those people who prefer not to take prescription drugs because i want to manage things naturally whenever i can. But I also recognize that there have been situations in my life where without medications I would have lost my life...like cancer. 

Controlling blood sugar is also one of those situations. I watched my father lose his lie to this terrible disease and I don’t ever want to see that again. So give yourself a break. If you need medical support, ask for it. And know that oftentimes once you get your lifestyle and your blood sugar in check you can discontinue these meds with the consent of your dr. 

And if you can’t so what… you do you...just keep trying to live the healthiest life you can and don’t beat yourself up if you can’t reach all the metrics ...I mean you’re the one who set them in the first place, so if they're causing you to suffer, change the expectation!

And if you want my support and guidance, come over to the breastcancerrecovery coach .com and get into the reviviy program while it's at its lowest price ever. I’d love to support you.

Be good to yourself and I’ll talk with you again next week.

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