Pathways to Prevention (P2P) Program

Bette Caan, Dr.P.H.

Dr. Caan

Kaiser Permanente Northern California Division of Research

Presentation Abstract

Low Muscle (Sarcopenia) and Low Muscle Radiodensity (Myosteatosis) and Cancer Outcomes  

This presentation will discuss the role of low muscle (sarcopenia) and low muscle radiodensity (a characteristic of muscle indicating excess fatty infiltration) among cancer patients and how these conditions affect cancer outcomes. Both low muscle and low muscle radiodensity indicate a form of malnutrition in cancer patients that is highly prevalent, occult and is significantly associated with decreased survival, and both increased surgical complications and co-morbidities. We will discuss how sarcopenia and low muscle radiodensity are commonly measured and defined in cancer patients and highlight potential problems with these definitions. We will discuss the prevalence of these conditions across cancer types. We will present potential mechanisms leading to these conditions, the current evidence for each of these conditions leading to poorer cancer outcomes and potential mechanisms relating these conditions to inferior cancer outcomes. Lasty, we will identify important research gaps in the field considering gender, ethnicity and stage, and present ideas for future research. 

About Dr. Caan

Dr. Bette Caan is a Senior Research Scientist and a Nutritional Epidemiologist at the Kaiser Permanente Northern California Division of Research (DOR). She has been at the DOR since 1983. Dr. Caan holds a master’s degree in nutrition from Columbia University, a master’s degree in epidemiology from the University of California, Berkeley, and a doctorate in public health nutrition from the University of California, Berkeley. Dr. Caan directs a research program in the examination of modifiable lifestyle risk factors in cancer survivorship, with a focus on body composition and energy balance risk factors. She initiated the Early Stage Investigator Training Program at the DOR and is the past Director. She has expertise in the assessment of diet and body composition and the conduct of dietary intervention trials. Dr. Caan has authored or co-authored approximately 500 publications while a researcher at DOR. Her research publications cover a wide range of topics, primarily in nutrition and body size, cancer epidemiology, and women’s health. Dr. Caan is currently the Principal Investigator of several federally-funded research projects including an intervention trial studying the effects of strength training on reducing side effects of chemotherapy in CRC patients, and the Life and Longevity after Cancer (LILAC) Women’s Health Initiative (WHI) Cancer Survivor Cohort; a cohort of 20,000 older women diagnosed with cancer during the WHI follow-up period currently being followed for recurrence and survival, and survivorship outcomes. She is also the recipient of two newly awarded trials, one examining the effect of varying doses of aerobic exercise during chemotherapy on chemotoxicities, and one on understanding distinct phenotypes of cachexia arising from advanced colorectal, pancreatic, and lung cancer. She recently completed two large observational studies examining the effects of body composition on breast and colorectal cancer outcomes (B-Scans and C-Scans). Dr. Caan has recently published several papers on the obesity paradox in cancer advocating that body mass index (BMI) misclassifies patients’ adiposity, and that we must move beyond BMI to accurately assess risk, and appropriately target patients for interventions. However, equally important in explaining the obesity paradox is that low muscle or sarcopenia is an important, underappreciated risk factor for poor survival, and normal weight patients with cancer should be screened for sarcopenia.

Dr. Caan did not disclose any conflicts of interest for this workshop.

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