THE ROLE OF OBESITY IN
CANCER SURVIVAL AND RECURRENCE:
A WORKSHOP
October 31-November 1, 2011
The Keck Center of the National Academies, Room 100
500 Fifth Street, NW, Washington, DC 20001
DAY 1
| 8:15 am |
Welcome from the IOM National Cancer Policy Forum |
| 8:20 am |
Workshop Introduction and Overview |
| 8:30 am |
Session 1: Role of Obesity and Weight Gain in the Promotion of Various Cancers Overview of the role of obesity in cancer risk and progression – Susan Gapstur, American Cancer Society Evidence for the role of obesity in breast cancer progression – Pamela Goodwin, Mount Sinai Hospital, University of Toronto |
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Evidence for the role of obesity in prostate cancer progression – Elizabeth A. Platz, Johns Hopkins Bloomberg School of Public Health Obesity, energy balance, and colorectal cancer survivorship – Jeffrey Meyerhardt, Dana-Farber Cancer Institute The impact of weight loss on cancer incidence and mortality – Bruce M. Wolfe, Oregon Health & Science University Correlations of obesity, comorbidity, and treatment: – Rachel Ballard-Barbash, NCI |
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| 10:30 am |
Panel Discussion • What is the current state of the evidence? What are the evidence gaps? • Is the evidence strong enough to recommend weight loss for individuals who are overweight or obese and who are either newly diagnosed with cancer or long-term cancer survivors? • Would such an approach be recommended for all survivors or a subset of individuals diagnosed with specific cancers? If the latter, which cancers are those? • What is the downside of recommending weight loss to cancer survivors who are overweight or obese given the high incidence of comorbidity in this population? • What are the methodological issues for closing the evidence gaps? • How do we adjust data on obesity for other factors such as physical activity and diet? |
| 11:15 am | Lunch Break |
| 12:15 pm | Session 2: Mechanisms by Which Obesity May Influence Cancer Progression Moderator: Stephen Hursting, University of Texas at Austin |
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Overview of mechanisms – Nathan Berger, Case Western Reserve University School of Medicine Increased risk of cancer in obesity and type 2 diabetes – Derek LeRoith, Mount Sinai School of Medicine Growth factor and energy sensing pathways – John DiGiovanni, University of Texas at Austin Hormonal factors in obesity and breast cancer – Angela Brodie, University of Maryland Obesity and breast inflammation: Implications for carcinogenesis – Andrew Dannenberg, Weill Medical College of Cornell University Obesity, stem cells, and cancer – Madhuri Kakarala, University of Michigan Signaling pathway crosstalk/Systems biology – Nathan Berger, Case Western Reserve University School of Medicine |
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| 2:30 pm |
Panel Discussion |
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• What is the evidence to support a role for the various potential mechanisms underpinning the obesity–cancer link? • What are the most pressing unanswered questions about mechanistic pathways? • What mechanisms are the most viable targets for pharmacologic or other interventions? • Are multipronged approaches feasible? Should the focus be on combination therapies and interventions? • How easy is it to measure the intermediate biomarkers that have been suggested? – For which of these biomarkers are there reliable assays? – For which are there limited means to assess specific levels? – What barriers exist in determining levels in humans? (e.g., is fresh frozen tissue necessary for assessment?) |
| 3:30 pm |
Break |
| 3:45 pm |
Session 3: Dissecting the Obesity–Cancer Link—Is It Obesity? Energy Balance? Physical Activity? Overview – Wendy Demark-Wahnefried Mechanistic insights from animal models – Stephen Hursting, University of Texas at Austin Clinical evidence – Jennifer Ligibel, Dana-Farber Cancer Center |
| 4:45 pm |
Panel Discussion |
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• What is the ultimate driver of the obesity–cancer link? • Are the relationships between physical activity and energy restriction in cancer similar to those in other diseases such as cardiovascular disease, or does cancer represent a different model? • What model systems and research methodologies could help us sort out the various contributions to the obesity–cancer link? • What is needed for effective clinical studies? • If we are able to discern the factors most influential in cancer promotion, would that necessarily change medical practice? • How might we best break the obesity–cancer link? |
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| 5:15 pm |
Wrap-up, Day 1 |
| 5:30 pm |
Adjourn Day 1 |
DAY 2
| 8:30 am |
Session 4: Tying It All Together |
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Overview of weight loss interventions for obese adults – Thomas Wadden, University of Pennsylvania Physical activity interventions in cancer survivors: What works? – Kerry Courneya, University of Alberta Evidence from diet and weight loss studies for cancer survivors: What works? – Cheryl Rock, University of California, San Diego Interventions in cancer survivors; issues and challenges in this population – Anne McTiernan, University of Washington When do we have enough evidence to intervene in cancer patients? – Patricia Ganz, UCLA |
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| 10:30 am |
Panel Discussion Questions: |
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• When is there enough evidence to warrant intervention? • What interventions are effective? What is the evidence? • When is the teachable moment? • What are the mechanics of intervention: Who, when, where, how, and what? • Which interventions are likely to be the most cost-effective? • What barriers stand in the way of broad dissemination on interventions? |
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| 11:30 am |
Lunch Break |
| 12:00 pm |
Session 5: Reactions and Panel Discussion—What Are the Policy and Research Implications? |
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Lori Minasian, Division of Cancer Prevention, NCI • What are the research needs and goals to advance understanding of this topic? • What resources and infrastructures are needed to accomplish the research goals? • What is needed for effective interdisciplinary research in this area? • What policy changes do you suggest to reduce obesity-related cancer incidence and mortality? • What are the obstacles to implementing such policy changes? How could those obstacles be overcome? • How can we work with other medical fields to accomplish common goals? |
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| 1:00 pm |
Closing Remarks—Wendy Demark-Wahnefried |
| 1:10 pm |
Adjourn |
