title: American Society of Clinical Oncology position statement on obesity and cancer.
abstract: Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team--the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis--is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer.
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA. jligibel@partners.org.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ligibel
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Burger
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Rowan T
authors.initials: RT
authors.lastname: Chlebowski
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Fabian
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Ayca
authors.initials: A
authors.lastname: Gucalp
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Madhuri
authors.initials: M
authors.lastname: Kakarala
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Janette K
authors.initials: JK
authors.lastname: Merrill
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Dana S
authors.initials: DS
authors.lastname: Wollins
authors.affiliation: Jennifer A. Ligibel, Dana-Farber Cancer Institute, Boston, MA; Catherine M. Alfano, National Cancer Institute, Bethesda, MD; Kerry S. Courneya, University of Alberta, Edmonton, Alberta, Canada; Wendy Demark-Wahnefried, University of Alabama at Birmingham, Birmingham, AL; Robert A. Burger, University of Pennsylvania, Philadelphia, PA; Rowan T. Chlebowski, Harbor-University of California Los Angeles Medical Center, Torrance, CA; Carol J. Fabian, University of Kansas Medical Center, Westwood, KS; Ayca Gucalp, Lee W. Jones, and Clifford A. Hudis, Memorial Sloan-Kettering Cancer Center; Dawn L. Hershman, Columbia University Medical Center, New York, NY; Melissa M. Hudson and Kirsten K. Ness, St Jude Children's Research Hospital, Memphis, TN; Madhuri Kakarala, Van Andel Institute, Grand Rapids, MI; and Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA.
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
mesh_terms: D035843:Biomedical Research; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D009937:Organizational Objectives; D010819:Physician's Role; D015995:Prevalence; D011322:Primary Prevention; D012307:Risk Factors; D012955:Societies, Medical; D014481:United States / Q000453:epidemiology