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Approaches to Morbidly Obese Women with Gynecologic Cancer

  • Gynecologic Oncology (C Feltmate, Section Editor)
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Abstract

Modifiable lifestyle factors, such as obesity, contribute significantly to cancer and preventable death worldwide. This review appraises recent evidence on the relationship of obesity with endometrial cancer, ovarian cancer, and other gynecologic malignancies as well as new evidence for the best surgical and medical practices in morbidly obese female cancer patients, including utilization of minimally invasive surgery, cytoreductive surgery, appropriate chemotherapy dosing, and optimizing radiation therapy in this population. For gynecologic cancer survivors, physical activity and weight loss are associated with improved health and quality of life. Interventional trials show promise in increasing physical activity and weight loss. Women’s cancer care providers should integrate counseling about obesity in the management of survivors of gynecologic cancers.

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Authors and Affiliations

  1. Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Karime K. Machado & Amanda N. Fader

  2. Johns Hopkins University School of Medicine, 600 N. Wolfe St, Phipps 287, Baltimore, MD, 21287, USA

    Amanda N. Fader

Authors
  1. Karime K. Machado
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  2. Amanda N. Fader
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Correspondence to Amanda N. Fader.

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Conflict of Interest

Karime Kalil Machado and Amanda N. Fader declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors

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Key Points

• Obesity is a major health problem that increases the overall risk of cancer and contributes to a worse prognosis in cancer survivors.

• Newer evidence suggests that obesity is a risk factor not only for endometrial cancer but also for ovarian, cervical, and vulvar cancers.

• The economic burden associated with obesity treatment is remarkable, and cost-effective strategies must be planned.

• Morbid obese gynecologic cancer patients have an increased risk of perioperative morbidity and mortality, given the multiple cardiovascular, endocrine, and other comorbidities associated with being overweight or obese.

• Minimally invasive laparoscopic and robotic-assisted approaches minimize postoperative complications in obese endometrial cancer patients and should be the standard of care in this setting when uterine-confined disease is anticipated.

• In ovarian cancer patients, morbid obesity is not a contraindication to radical cytoreductive surgery, when performed by experienced surgeons.

• Health-care providers should provide adequate counseling in weight management and healthy lifestyle for gynecologic cancer survivors.

This article is part of the Topical Collection on Gynecologic Oncology

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Machado, K.K., Fader, A.N. Approaches to Morbidly Obese Women with Gynecologic Cancer. Curr Obstet Gynecol Rep 5, 286–295 (2016). https://doi.org/10.1007/s13669-016-0181-z

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  • DOI: https://doi.org/10.1007/s13669-016-0181-z

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