Obesity and Cancer: What can we learn from weight loss studies?. Faina Linkov, PhD Research Assistant Professor University of Pittsburgh Cancer Institute. What is cancer?.
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Faina Linkov, PhD
Research Assistant Professor
University of Pittsburgh Cancer Institute
Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems. Cancer is not just one disease but many diseases. There are more than 100 different types of cancer.
We all know about dangers of smoking in relation to cancer, however when it comes to dangers of obesity in relation to cancer, there is some state of confusion.
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Adipose tissue is an active endocrine organ
Mechanisms by which adipose tissue may influence cancer risk
- Production of sex steroid hormones (e.g., estrogen, androgen)
- Effects on insulin sensitivity and production of insulin-like growth factors
- Actions on other hormones in adipose tissue (e.g., leptin, adiponectin)
- Increases in oxidative stress and chronic low-grade inflammation that affect the body’s immune response
2003 and cancer?
2009 Cancer Risk Awareness cancer?
Percentage of Americans who Believe it to be a Cause of Cancer
Percentage of Americans Who Consider It “Highly Preventable”
How much excess weight is too much??? Preventable”
For adults ages 25-59, increased mortality in underweight and obese categories, but not overweight category.
Cancer Prevention Study II
Calle, E. et al. N Engl J Med 2003;348:1625-1638
Cancer Prevention Study II
Effects of bariatric surgery on cancer incidence in obesepatients in Sweden (Swedish Obese Subjects Study):a prospective, controlled intervention trial
First intervention trial in the obese population to provide prospective, controlled cancer-incidence data.
The SOS study started in 1987 and involved 2010 obese patients (body-mass index [BMI] ≥34 kg/m2 in men, and ≥38 kg/m2 in women) who underwent bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. While the main endpoint of SOS was overall mortality, the main outcome of this exploratory report was cancer incidence until Dec 31, 2005.
Endometrial cancer risk reduction in the context of weight loss through bariatric surgery
Obesity as a risk factor
In comparison with women who maintain a healthy weight, endometrial cancer is twice as common in overweight women, and more than three times as common in obese women.
It is particularly interesting to explore weight loss in relation to endometrial cancer risk because limited evidence suggests that premalignant changes in the endometrium can potentially be reversed with achieving more optimal weight.
Examine the effects of weight loss surgery on a selected set of biomarkers associated with the risk of endometrial and other obesity-linked cancers 6, 12, and 24 months following surgery
Investigate the relationships between the magnitude of the weight loss achieved at 6, 12, and 24 months following surgery and the quantitative measures of the biomarkers on the obesity-linked cancer risk panel.
To explore the possible additional contribution of changes in physical activity levels and psychological factors to the changes in quantitative measures of the biomarkers on the obesity-linked cancer risk panel.
A healthy diet can help sustain a healthy weight and lower risk of cancers
Regular physical activity protects against the buildup of excess body fat and against cancer, independently
Bariatric surgery may be used as a measure of last resort for people who cannot lose weight through traditional means