Fat cells may hinder the effect of chemotherapy
It’s not newsworthy that obesity leads to a litany of health problems, from heart disease and high blood pressure to diabetes, sleep apnea and cancer. But for cancer patients, a new study suggests obesity can cause more medical complications by interfering with efforts to treat the disease. Citing findings from research published in Molecular Cancer Research , a report from the National Cancer Institute demonstrates how fat cells can reduce the effectiveness of chemotherapy drugs. “Researchers have shown that fat cells can absorb two commonly used chemotherapy drugs, and chemically break them down into less toxic forms, which may reduce the drugs’ effectiveness” in some cancers, NCI staff say in a recent blog post about the study.
According to the study, “through the uptake and breakdown of drugs, fat cells can remove drugs from the environment surrounding cancer cells in the bone marrow or other areas of the body where fat cells are abundant.” “This finding may help explain why obesity is associated with worse outcomes in different types of cancer.” The study’s lead author notes that the research appears to be the first to provide evidence that fat cells can “metabolize and inactivate.” Therapeutic drug number .
How does the study add to the previous findings?
Doctors previously noted that obese children with acute lymphoblastic leukemia were 50 percent more likely to have a recurrence than their non-obese counterparts. Obese patients with breast, colon, ovarian and prostate cancer did worse than those who were not obese. Damien Hansra, MD, a medical oncologist at our hospital in Metro Atlanta, explains that chemotherapy drugs work by affecting the ability of cancer cells to divide so tumors don’t grow and spread. But researchers are discovering that obesity complicates the effect of the drugs by altering the tumor’s microenvironment or the cells, molecules, and blood vessels that surround and nourish the tumor cell. This process creates a biological environment for obese patients that can lead to tumor growth.
Obesity increases inflammation which has been linked to a variety of cancers. A University of Miami study published in 2017 found that “obesity is associated with an increased risk of breast cancer, especially in postmenopausal women, and worse disease outcomes in women of all ages.”
People who are overweight and obese are more likely to have medical conditions that cause chronic inflammation, which increases the risk of some cancers. In the leukemia study, researchers found that fat cells, which produce high levels of certain enzymes, can break down a class of chemotherapy drugs known as anthracyclines. Some of these enzymes are found in fat cells in the bone marrow of children being treated for acute lymphoblastic leukemia. According to the study, the uptake or deconcentration of certain anticancer drugs could contribute to the “development of drug-resistant cancer cells.”
Over the years, underdosing in obese cancer patients, due to concerns about cardiotoxicity (heart damage caused by chemotherapy drugs), has sparked controversy, says Dr. Hansra. But in 2012, the American Society of Clinical Oncology, after examining the issue, recommended the use of “weight-dependent total doses of cytotoxic chemotherapy for the treatment of patients with obese cancer, particularly when treatment is treatment. There is no evidence that the toxicity is short or Long-term increases among obese patients receiving full doses on a weight basis.”
Dr. Hensra is passionate about educating his patients about the serious health risks of obesity.
“Obesity is a preventable, polygenic systemic inflammatory disease”. Damien Hansra, medical oncologist
“It’s a sure sign of poor health,” he says. “The main syndromes associated with obesity are cardiovascular disease, cerebrovascular disease (affecting the brain, blood vessels and arteries), diabetes, high cholesterol, high blood pressure, kidney disorders, and musculoskeletal disorders, all of which require taking more medication. Add chemotherapy, hormonal therapy, and/or radiotherapy to an already sick patient, and that will be a disease storm, and you will see more and more adverse drug reactions.”