Weight management is vital in preventing cancer

When it comes to reducing cancer risk, maintaining a healthy weight can be just as important as avoiding tobacco and excessive sun exposure. In fact, the American Cancer Society (ACS) has found that those who lead a healthy lifestyle, by following a nutritious diet, reducing alcohol consumption and taking other important steps, are 10 to 20 percent less likely to develop cancer.

These are significant numbers when you consider that nearly 70 percent of adults in the United States are overweight (defined as a body mass index, or BMI, 25 to 29.9) or obese (with a BMI of 30 or more). First recognized as a disease by the American Medical Association in 2013, obesity is expected to soon overtake tobacco as the leading preventable cause of cancer, according to the American Society of Clinical Oncology (ASCO).

Obesity has been linked to 13 types of cancers: uterus, esophagus, liver, stomach, kidney, brain, multiple myeloma, pancreas, colon, rectum, gallbladder, ovary, breast, and thyroid, but more than half of these Americans know it is. A risk factor for cancer. Many patients are open to learning more about the relationship between obesity and cancer risk and outcomes, says Carolyn Lammersfeld, MD, vice president of integrative medicine at the Cancer Centers of America (CTCA). “My experience is that many people with cancer know they have excess weight and want to do something about it, but many don’t know that there is a relationship between cancer and weight gain, including cancer outcomes,” he said. . He says.

What causes the relationship between obesity and cancer?

According to the National Cancer Institute (NCI), there are several possible causes, including chronic inflammation, that may be present in people with obesity. Excess insulin and other hormones such as estrogen can increase cell division or stimulate the growth of cancer cells. In fact, several studies have indicated that obese women may have an increased risk of developing breast cancer after menopause, possibly due to increased estrogen. In postmenopausal women, the ovaries stop producing estrogen and adipose tissue becomes the main source of estrogen in the body. If these women are obese, the extra fatty tissue can produce higher levels of estrogen, which can lead to faster growth of some breast tumors.

The association of cancer with obesity does not end with risk. Being overweight is also associated with worse outcomes, according to the ASCO, including effects on surgical outcomes and prognosis, chemotherapy-related complications and an increased risk of secondary cancer. Because of these and other complications, treating cancer patients who are overweight or obese is more complex, says Dr. Ricardo Alvarez, MD, director of cancer research and a breast oncologist at our hospital near Atlanta. This is why he usually spends a third of his time with patients discussing diet and exercise. “My suggestion to them is to always do a physical activity they enjoy, like swimming or Zumba®,” he says.

Of course, obesity is not only caused by poor diet and lack of exercise. Some people have a genetic predisposition to being overweight, says Dr. David Boyd, M.D., an admissions doctor at our hospital near Phoenix. “In those cases, losing weight isn’t as easy as ‘energy input’ versus ‘energy production,'” he says. “When you look at different factors for different people, it gets more complicated.”

Count the constant battles with weight amidst those complications, especially for future generations of cancer patients. With childhood obesity statistics at an all-time high, the condition is affecting more people early in life, meaning the link between obesity and cancer could become even more challenging. “It wasn’t long until we started seeing type 2 diabetes in children when we only saw type 1 diabetes in children,” says Dr. Boyd. “Think about it: We now live in a society where we don’t feel like we can send our children outside to play without supervision. It has affected our children’s health.”

The effect of childhood trauma

In other cases, childhood trauma can lead to eating disorders that become long-lasting and difficult to treat. One large research study, for example, found that many obese patients surveyed about their childhood experiences reported experiencing emotional, physical, or sexual trauma when they were young. Along the way, after experiencing higher and more stable stress levels than their peers, a large number of them began using eating as a coping mechanism. It’s not just a behavioral solution,” says Dr. “There are many psychological, social, mental and physical aspects of people in terms of why they engage in unhealthy lifestyles. If we had a more empathetic understanding of that, we would have more effective interventions to prevent or treat obesity.”

Lammersfeld says he believes setting realistic goals is also the key to overcoming obesity. “The best way we can help patients is by targeting SMART goals for them, such as losing 5 percent of their body weight, as a start,” she says. “We have to try to help people, in the most supportive way possible, lose small amounts of weight if they can, so that they can achieve better results.”

Dr. Alvarez has developed a plan for a specific group of patients – women with breast cancer – and is studying its effects. The idea came to her after learning in 2015 that 82 percent of breast cancer patients are overweight or obese. In November 2016, Dr. Alvarez launched the Energy Balance Research in Cancer (EnBaR) study to determine whether incorporating weight management and physical activity programs into cancer care would translate into better outcomes. As part of the study, patients check in with a dietitian twice a month to discuss pre-set goals, such as activity level, diet, smoking, alcohol, sleep, and motivation, and to track progress. “We need to define a clear strategy on how to treat obesity, especially as more and more cancer survivors are living longer,” says Dr. Alvarez.

Cancer does not differentiate and prevention is not foolproof. Dr. Boyd says you have important opportunities to take charge of your own health. “You can’t change your genes, but you can make lifestyle modifications since childhood,” he says. “Look at it this way: You don’t want to stack things up in favor of having cancer, or if you’ve already been diagnosed with cancer, exacerbate your prognosis. You want to do everything you can to improve your chances.”