Colon Cancer, Obesity and Bariatric Surgery

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testing765
Posts: 313
Joined: Tue Aug 19, 2014 9:41 am

Colon Cancer, Obesity and Bariatric Surgery

Postby testing765 » Mon Oct 24, 2016 11:30 am

Hi, I will be seeing a bariatric surgeon this week. I've always been at least 10 or 15 pounds overweight. But I am now at least 70 pounds over ideal weight. I thought it was only going through treatment for colon cancer, that caused me excessive weight gain. The surgery and the chemo wore me out, the steroids I had to use to treat the chemo side effects also affected my weight and I was not making good food choices. My oncologist raised bariatric surgery as a possible treatment for the obesity. My primary care doctor is ok with the idea, she just wanted to make sure that I was mentally and physically prepared for another surgery.

My BMI is about 36. That BMI level, plus having at least two co-morbidities, high blood pressure and sleep apnea, will qualify me for insurance coverage.

I've found some studies that suggest excess weight increases the risk of developing certain forms of cancer. But I've also seen a study that suggests that those who have had bariatric surgery have a greater likelihood of colon cancer after the surgery. Ann Surg. 2013 Dec;258(6):983-8, Increased risk of colorectal cancer after obesity surgery.

I have some records of my weight and I see that as far back as 2012 I was at least 60 pounds overweight. So this weight problem has been with me for awhile, both before and after cancer treatment.

I've tried calorie restriction and exercise in the last few years but it hasn't helped. In the past I've used slimfast, Atkins, weight watchers, etc. They all worked, but I gained the weight back.

I am an emotional eater. What will happen if I continue to eat based on emotions after I have bariatric surgery? I recognize that surgery will not cure the emotion based eating.

I am considering either lap band or gastric sleeve. I would like to know anyone's experience with these surgeries. Were the side effects really difficult to deal with? How did you decide which surgery was better for you?

Do you think that the reduction of the likelihood some cancers outweighs the potential increase in colon cancer likelihood?

Finally, I am aware that bariatric surgery is not a quick fix or a cure all.
Last edited by testing765 on Mon Oct 24, 2016 4:11 pm, edited 1 time in total.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

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WriterGirl1969
Posts: 493
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby WriterGirl1969 » Mon Oct 24, 2016 12:46 pm

I don't have any helpful info to provide, but I'm particularly interested in this thread because I was considering gastric bypass before being diagnosed with cancer, and wondered some of these same points, so I'm eager to see what everyone has to say. Like you, I'm worried that the surgery could mean I can't get as many nutrients, but thinking the weight loss and better diet could be beneficial. Hard to know which way to go.

Anyway, I'll be keeping an eye on this thread.
--Tracy
DX 3/4/2016 Colon Cancer; age 46 Mom of 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Left Hemi
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
3/6/17 CT clear; 4/17/18 CT clear;
NED 2 years
“If I can help somebody as I walk along, then my living shall not be in vain.”

rmblack
Posts: 27
Joined: Mon Oct 13, 2014 1:47 am

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby rmblack » Mon Oct 24, 2016 2:25 pm

I've wondered about his also. I was overweight before my diagnosis and now it's even worse. I've gained roughly 50 pounds since my diagnosis and it's not coming off. I want to be NED for at least a year before I consider it again. But I'm anxious to hear if anyone else has done this.
Rhonda- 41
Wife and mom of 2 (21 and 22)
Diagnosed 9/12/14
Stage 3 Colon Cancer
Surgery 10/6/14
30 radiation treatments
6 months chemo. Oxy and xeloda
NED 7/18/15
Reoccurrence 4/2016 in abdominal wall
Surgery 4/2016
Stage 4
KRAS wild
3 months of Erbitux (May-July 2016)
20 radiation treatments
NED 8/10/16
January 2017 CLEAR SCANS!!!

Philippians 3 14

Dori W
Posts: 29
Joined: Mon Aug 25, 2014 2:30 pm
Facebook Username: Dori Woodhouse

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby Dori W » Mon Oct 24, 2016 3:49 pm

Hi,

I had gastric sleeve surgery in 2012, about five years after my colon cancer diagnosis.

The good:

- I healed well and did not have any complications.
- I lost 60 pounds.
- I thought, from my reading, that the increased cancer risk was only with the gastric bypass surgery, but I don't have any idea if that is correct. It could be that other surgeries were not studied, come to think of it.
- I think most people have good weight loss results.
- I got my bad gall bladder out in the bargain.

The bad:

-I lost 60 pounds! But I needed to lose closer to 100.
-I've regained about 32 pounds of the 60 I lost.
- I feel a little traumatized by my surgeon. He said things like I "couldn't possibly" be hungry after the surgery (I was) and that I could only eat tiny amounts at one time (not true). And that I should only be eating 800 calories per day (yeah, right). I felt like my experience was not accepted by him and was not being taken seriously.
- Having said that, I definitely see now that i have food and eating issues that surgery could not fix.
- Although I had no complications, some people do, and they can be very serious.

I waited five years after my cancer diagnosis before having surgery, which was necessary in my case because I was at high risk of recurrence. I would absolutely follow doctor's recommendations on how long to wait.

Good luck!

Dori
Diagnosed stage 3C signet ring colon cancer in May, 2008
14 out of 18 positive lymph nodes
Final treatment in November, 2008
NED ever since
I used to have an account under "Dori," but I've lost access to it.
You can view my old posts here: search.php?author_id=1446&sr=posts

testing765
Posts: 313
Joined: Tue Aug 19, 2014 9:41 am

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby testing765 » Mon Oct 24, 2016 4:20 pm

Hi Dory W. Thank you for sharing your experience with me. It is helpful information. I know this surgery is a big decision, so I want to consider of all the relevant factors before i decide whether or not to go through with it.

Hopefully my surgeon wont be as traumatizing as yours was.

Since my oncologist proposed the idea, I assume that he believes my cancer prognosis is good enough to move forward with bariatric surgery.

I am going to make a list of questions to bring with me to the surgery. And I will need to see a gastroenterologist, a behavioral therapist, a dietician and a cardiologist before I could schedule any type of surgery.

Thanks again.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

jhocno197
Posts: 817
Joined: Mon May 11, 2015 9:33 pm

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby jhocno197 » Mon Oct 24, 2016 9:51 pm

The three people I know who have had bariatric surgery all put most of the weight back on afterwards, unfortunately.
DH - dx Dec 2014, stage IV with bladder & peritoneal involvement - non-resectable
Colostomy
FOLFOX failed
FOLFIRI failed
Tumor actually distending pelvic skin
Not a candidate for last-ditch pelvic exenteration
Stivarga finally begun 2/19/16
Tumor growing/fungating
Lonsurf started 11/18/16
Died 3/10/17

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cashmere
Posts: 305
Joined: Wed Jul 15, 2009 2:52 pm

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby cashmere » Tue Oct 25, 2016 7:52 am

I wanted to chime in because I was morbidly obese most of my early days. I am not an emotional eater so I do have that going for me. I lost 130 pounds through weight watchers when I was 26 and kept it off for many years until I was diagnosed in 2007. During treatments I gained 20-25 pounds and really struggled with getting it off. Going thru treatments and instant menopause were the reasons for my weight gain.

I wanted to address your emotional eating. IMO, you should address that first, some type of therapist. I feel until you can understand that, the bariatric surgery will help initially but it will be very difficult to keep the weight off. I know of 2 people in my life that had the surgery and although they did lose weight, they have gained most of it back.

I am sorry to be a downer, Pearl
Stage III
Diagnosed 4/07 at 51
36 rad/24/7 chemo bag
surg 9/07
6 mon chemo w/48 hr bag
ileo reversal 5/08
NED since 9/07!!
Just resolved my 13th blockage
Been able to control blockage issues with fiber supplements!!

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WriterGirl1969
Posts: 493
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby WriterGirl1969 » Tue Oct 25, 2016 8:22 am

It's important to remember that surgery is a means to an end, not a cure-all. It allows you time to change habits and make new / better ones. My husband has had it, and lost over 150lbs. He's gained back about 20, but continues to stay at a much more healthy weight than he was at before the surgery. We met with a local support group for a long time to hear all the ins and outs. What we ultimately decided was, even with a scenario where we gained the weight back in 5 or 10 years, at the very least we would have bought ourselves 5 or 10 more years of life and a chance to change our habits.

When hubby first had the surgery, he could eat very little. Even now, six years later, he has trouble if he eats too much. So it does keep him from overeating to the extent he was doing it before. It does *not* stop him from eating foods that aren't good for him. That is a choice / habit. For instance, he might still have a cookie. Some types of desserts do bother him now, although it's difficult to say if that's a result of the surgery or just part of getting older. It took about six months for him to be able to eat all the same types of foods as pre-surgery, and about a year before he was starting to increase his meal-sizes a bit. While your body is only able to intake a certain amount, it's a time to try and change those habits. For example, it's much easier to walk and exercise when you are down 50 or 100 lbs, because your joints and muscles don't hurt as much. It gives you that time to start taking advantage of those changes in your body. That's really what the surgery provides you. Some extra time.

That, and in the case of bypass, immediate end to type-2 diabetes. Not sure if they still say it, but we were told that as soon as you come out of surgery you are no longer diabetic. Blood testing while in recovery seems to support this - at least it did with Hubby. My understanding is that bypassing the duodenum is the general thought as to how that works. At one point I'd heard they were looking at bypass surgery as a treatment for diabetes. Not sure what recent studies show.
DX 3/4/2016 Colon Cancer; age 46 Mom of 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Left Hemi
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
3/6/17 CT clear; 4/17/18 CT clear;
NED 2 years
“If I can help somebody as I walk along, then my living shall not be in vain.”

testing765
Posts: 313
Joined: Tue Aug 19, 2014 9:41 am

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby testing765 » Tue Oct 25, 2016 9:08 am

cashmere wrote:I wanted to address your emotional eating. IMO, you should address that first, some type of therapist. I feel until you can understand that, the bariatric surgery will help initially but it will be very difficult to keep the weight off. I know of 2 people in my life that had the surgery and although they did lose weight, they have gained most of it back.


Hi. Yes I agree, I need to address the root causes of the emotional eating. I would hate to go through the surgery just to gain all of the weight back again.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

testing765
Posts: 313
Joined: Tue Aug 19, 2014 9:41 am

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby testing765 » Tue Oct 25, 2016 9:11 am

WriterGirl1969 wrote: We met with a local support group for a long time to hear all the ins and outs. What we ultimately decided was, even with a scenario where we gained the weight back in 5 or 10 years, at the very least we would have bought ourselves 5 or 10 more years of life and a chance to change our habits.


Hi. How did you find the local support group that you attended? Was it specifically for people who had bariatric surgery or did include anyone dealing with a weight problem?
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

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WriterGirl1969
Posts: 493
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby WriterGirl1969 » Tue Oct 25, 2016 6:49 pm

testing765 wrote:Hi. How did you find the local support group that you attended? Was it specifically for people who had bariatric surgery or did include anyone dealing with a weight problem?


This was several years ago (6?) and before hubby's surgery. At that time, most health insurances required people to lose 5% of current weight on their own, as well as attend a set number of support group meetings (3?) prior to having the surgery. The hospital hubby was getting his with gave him a list of local groups, and we met up with the one closest to home. It included people getting various types, and some who were just "considering" it, so I would say it included a good variety. These days, you could probably google to find local groups, or contact a surgeon / doctor's office that provides bariatric and ask if they have a referral list for support groups in your area.
--Tracy
DX 3/4/2016 Colon Cancer; age 46 Mom of 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Left Hemi
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
3/6/17 CT clear; 4/17/18 CT clear;
NED 2 years
“If I can help somebody as I walk along, then my living shall not be in vain.”

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Jack&KatiesMommy
Posts: 520
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby Jack&KatiesMommy » Wed Oct 26, 2016 9:25 am

I have a very good friend that had lap band surgery 3 years ago. Unfortunately, he had/has an eating disorder and the surgery did not address the root cause. Although he lost 120 lbs during the first year, today (three years later) he is 30lbs heavier than he was before the surgery. He continued to eat as he did before and his stomach stretched back out to its original size.
Cynthia
Cynthia
Mommy to Jack (8) now (15) and Katie (4) now (11)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection!
8/13; 10/13; 12/13; 3/14; 8/14; 11/14; 2/15; 7/15; 12/15 RFA lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new mets lymph nodes in hilar/lung:
05/18: Started Keytruda (MSS but moderate mutation burden): CEA: 66.4, 39.2, 23.8, 13, 3.5 NOW 1.8
08/18 Clear CT scan

radnyc
Posts: 306
Joined: Tue Apr 06, 2010 6:32 pm

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby radnyc » Wed Oct 26, 2016 11:19 am

Obesity, BMI over 30, has been known to be associated with increased risks of the following cancer types, and possibly others as well:

Esophagus
Pancreas
Colon and rectum
Breast (after menopause)
Endometrium (lining of the uterus)
Kidney
Thyroid
Gallbladder

https://www.cancer.gov/about-cancer/cau ... fact-sheet

Particularly colon cancer. I've never been obese, but I wonder how many of us on here were/are when diagnosed. A very important reason to maintain a normal weight.
DX Jan '10, at 47
Feb - colon resection - 2/17 nodes
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April '11
HAI Pump removed Dec '15

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WriterGirl1969
Posts: 493
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Colon Cancer, Obesity and Bariatric Surgery

Postby WriterGirl1969 » Fri Oct 28, 2016 9:37 am

To quote my surgeon, "There are plenty of people who eat terribly and are overweight that do not get cancer. You did not cause this."

That's not to say that I couldn't benefit from a healthier lifestyle, but I firmly believe that you cannot prevent cancer by being "normal weight." If that were the case, we would not see so many posts about very healthy, normal weight people who exercise every day but still get cancer. It's an indiscriminate killer, and I would never want to promote a guilt factor to victims of it.
DX 3/4/2016 Colon Cancer; age 46 Mom of 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Left Hemi
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
3/6/17 CT clear; 4/17/18 CT clear;
NED 2 years
“If I can help somebody as I walk along, then my living shall not be in vain.”


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