Preventing Breast Cancer with Better Obesity Care?
For the first time, we have evidence that treating obesity might reduce the risk of breast cancer, even in women before menopause. The research, published in the Annals of Surgery, finds a lower risk of breast cancer in women with severe obesity before and after menopause if they have bariatric surgery.
Other studies have shown a reduction in risk for women after menopause. But this is the first suggestion of reduced risks for women before menopause.
An Observational Cohort Study
Right off the top, we note that these data are observational. Researchers studied detailed records for 17,998 female bariatric surgery patients and matched them to 53,889 similar patients who had no surgery. The matching accounted for age, BMI, location, and comorbidities. But as with any observational study, the possibility remains that something else accounts for the difference in breast cancer risk. For example, behavioral risks might have differed.
Nonetheless, these are important findings. They confirm observations from other studies for postmenopausal women. And they open up new questions about the relationship between cancer and obesity before menopause.
Growing Concerns About Cancer and Obesity
Cancer and obesity are two chronic diseases with with a link that’s becoming increasingly obvious. It’s a link that’s tough to study just because these diseases have a long timeline. The studies take a long time and with the passage of so much time, many confounding factors can come into play.
Regardless of the challenge, the importance of better understanding this problem has become unmistakeable. Obesity may soon become the leading cause of preventable cancers. That’s because declines in smoking have led to fewer cancers caused by tobacco use. But the rise in cancers linked to rising obesity rates might well erase all of that progress. And breast cancer is the most common cancer in women.
Recent data on obesity-related cancers in young people made this point quite clear. The numbers are going up. So we can’t afford to ignore evidence that better obesity care might offer a way to reverse this problem.
This is one more reason that irrational restrictions in access to effective obesity care should be intolerable.
Click here for the study and here for our recent presentation on the challenge of prevention and treatment for cancer and obesity.
Run for the Cure, photograph © Sangudo / flickr
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Month x, 2019
April 22, 2019 at 12:36 pm, David Brown said:
“Bariatric surgery was associated with a reduced risk of breast cancer among severely obese women. These findings have significant public health relevance because the prevalence of obesity continues to rise, and few modifiable breast cancer risk factors have been identified, especially for premenopausal women.”
An important modifiable risk factor for breast cancer is the imbalance in the essential fatty acid profile of one’s food intake. I Googled – arachidonic acid breast cancer young women. Here are some of the articles titles that came up:
Dietary Polyunsaturated Fatty Acids and Breast Cancer Risk in Chinese Women: A Prospective Cohort Study[1] (2010)
Role of dietary fatty acids in mammary gland development and breast cancer[2] (2010)
Current Evidence Linking Polyunsaturated Fatty Acids with Cancer Risk and Progression[3] (2013)
Omega-3 fatty acids for breast cancer prevention and survivorship[4] (2015)
Arachidonic Acid Metabolite as a Novel Therapeutic Target in Breast Cancer Metastasis[5] (2017)
As far back as 1999 researchers were connecting excessive omega-6 polyunsaturated fat intake to cancers of various sorts. Excerpt:
“Studies in animal models and recent observations in humans, have provided evidence that a high intake of ω-polyunsaturated fatty acids (PUFAs), stimulates several stages in the development of mammary and colon cancer, from an increase in oxidative DNA damage to effects on cell proliferation, free estrogen levels to hormonal catabolism. In contrast, fish oil-derived ω-3 fatty acids seem to prevent cancer by influencing the activity of enzymes and proteins related to intracellular signalling and, ultimately, cell proliferation. In this commentary, current evidence from experimental and human studies is summarized that implicates a high intake of ω-6 PUFAs in cancer of the breast, colon and, possibly, prostate and which indicates that ω-3 PUFAs and monounsaturated fatty acids such as oleic acid (ω-9) are protective.[6]
If high intake of ω-6 PUFAs is a causal factor for chronic inflammatory disease, than reducing omega-6 intake amounts to prevention and supplementation with ω-3 fatty acids should be regarded as a treatment. Excerpt:
Too few people recognize that nearly every cell and tissue in our body has hormone receptors that respond in different ways to omega-3 and omega-6 hormones. As a result, too many people fail to realize how many different disorders reflect an imbalance of these two types of hormone. Deeper insight comes from recognizing that each person’s balance of omega-6 and omega-3 hormone precursors depends predictably on the balance of vitamin-like omega-6 and omega-3 nutrients in foods that are eaten. Common health problems made worse by excessive omega-6 actions include cardiovascular and diverse immune inflammatory and psychiatric disorders such as atherosclerosis, arthritis, asthma, bone loss, cancer growth, heart attacks, length of hospital stays, depression, suicide, classroom disruptions, oppositional behavior and unproductive workplace behaviors.[7]
Clearly, there needs to be more emphasis on correcting and less emphasis on treating omega-3/6 imbalances.
References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086389/
2. https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr2646
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761560/
4. https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-015-0571-6
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086389/
6. https://academic.oup.com/carcin/article/20/12/2209/2529842
7. https://www.ncbi.nlm.nih.gov/pubmed/21827870