Endometrial cancer survivor lowers risk by lowering weight

Soon after undergoing surgery for endometrial cancer, Mary Zirino listened as her gynecologic oncologist cautioned her to lose weight.

"Fortunately, Mary had a very early stage of the disease, so I didn't recommend additional medical treatment beyond the surgery," said S. Diane Yamada, MD, chief of the Section for Gynecologic Oncology at the University of Chicago Medicine. "But her weight almost certainly contributed to development of the endometrial cancer, and it put her at risk for other types of cancer in the future."

Zirino dutifully lost a few pounds but returned to her old eating habits within a few months. "Cancer can mess with your head," she said. "On one hand, your doctor is telling you to lose weight, so no more cake. On the other hand, I just survived cancer, and life is short — eat the cake.''

Two and a half years after her endometrial cancer surgery, a routine mammogram showed something irregular. Follow-up scans were normal, but this second scare was all it took to put Zirino on a healthier path.

Like many people, she had gym equipment at home that went unused. Her husband Charlie set up their cross trainer, exercise bike and weights. She began working out for an hour most mornings before she left for her job as director of talent acquisition at a staffing agency.

Zirino gave up her daily diet sodas and starting drinking only water. A self-described creature of habit, she designed a new healthy meal plan: oatmeal and fruit for breakfast, a simple sandwich or salad for lunch, and grilled chicken or reasonably proportioned takeout for weeknight dinners.

"I thought changing my diet was going to be impossible," she said, "but I started sleeping better and feeling better. And I had so much more energy."

In spring 2017, Zirino sent her doctor photos that showed she had shed 56 pounds in six months.

"I was thrilled she lost weight and did so in a healthy way," Yamada said. "She is an inspiration for others."

Most of the endometrial cancer patients seen by Yamada and other UChicago Medicine gynecologic oncologists are overweight. And Yamada has found most patients are surprised to hear that obesity is a risk factor not only for diabetes and heart disease but also for uterine, breast and colon cancer.

"Endometrial cancer often can be just the tip of the iceberg," Yamada said.

Her colleague, Nita Karnik Lee, MD, has conducted focus groups with endometrial cancer survivors to examine barriers to weight loss. "Our findings highlighted the importance of a supportive social network in helping survivors modify their lifestyle," Lee said.

Zirino has had the support of friends, work colleagues and family. Charlie joined her on the quest to get healthy and has lost 20 pounds.

"We are in it together because we have so much more to see and do together," she said. "I have a new purpose. I never want to go back to being tired and sluggish, and I don't want to go to another appointment and hear a doctor say, 'You have cancer.' "