Two years ago, Tidelands Health breast surgeon Dr. Craig Brackett was in Miami attending an annual gathering of physicians from across the world who specialize in breast health.
Most of the 100-plus sessions during the conference lasted no longer than 15 to 20 minutes. Dr. Brackett listened intently as the keynote address extended longer than an hour.
The link between obesity and breast cancer.
For nearly his entire career, Dr. Brackett has encouraged his patients to maintain a healthy weight to help reduce their risk of cancer. The keynote address only reinforced the need for his continued advocacy on the topic.
“We talk about it every day,” he says. “Frankly, it can get a little monotonous for our nurses who hear it over and over, but it’s very important.”
The connection between obesity and breast cancer, especially among post-menopausal women, is well established. Repeated studies have shown that obese women are more likely to be diagnosed with breast cancer, tend to respond to treatment more poorly and are more likely to suffer a recurrence of cancer after treatment.
A 2014 study, for example, found that obese women have a 20 to 40 percent increase in the risk of developing breast cancer compared with normal-weight women, according to the National Cancer Institute.
The prevailing belief is that too much fatty tissue creates an imbalance of hormones that can lead to an increase in cancer-causing inflammation.
That’s one of the reasons why Dr. Brackett and the team at the Tidelands Health Breast Center, the region’s only surgical practice dedicated solely to breast health, addresses weight with patients. The center is part of the Tidelands Health Cancer Care Network, an affiliate of MUSC Health and the region’s most comprehensive provider of cancer care.
Weight is not an easy topic to broach, Dr. Brackett says, but it’s important. He believes obesity will soon overtake smoking as the leading risk factor for a variety of cancer diagnoses.
“Talking about weight can be difficult in normal circumstances, but it can be especially challenging when you consider what cancer patients are already going through,” he said. “Still, just because it’s not comfortable doesn’t mean it should be avoided.”
One of the core tenets of his practice is being upfront, he said. If there’s something the patient can do to gain more control of his or her health and recovery, it’s a physician’s responsibility to discuss it with the individual.
“I explain the physiology behind it, so they know why it’s important,” he says. “Some of our patients, they’ll come in for their six- or nine-month visit and they’ve lost 10 or 15 pounds.”
“It’s not easy to lose weight, but you’ve got to do it. We talk about facts and how hard it is and encourage them. If they see it in your eyes that you mean it and you’re earnest, they’ll listen to you.”