Weight Loss Surgery Linked to Drop in Cancer Risk: Study

OType 2 diabetes and hypertension are all linked to besity. It is often overlooked that besity can be closely linked with cancer.

A study was published in JAMAResearchers have provided the strongest evidence to date supporting obesity as a risk factor for cancer and weight loss surgery’s benefits in decreasing the likelihood of getting or dying from it.

There were more than 30,000. The results showed that people who underwent weight loss had a lower chance of 15 common types of cancer and had a reduced risk of death from them 10 years later.

“What we’ve observed here is a very large effect,” says Dr. Steven Nissen, a cardiologist at Cleveland Clinic and the senior author of the paper. “I think this data is as strong as is going to be available for quite some time to support yet another reason why weight loss is a really important public-health intervention.”

Dr. Ali Aminian, director of the bariatric and metabolic institute at Cleveland Clinic and the study’s first author, says that in order for people with obesity to lower their risk of developing or dying from cancer, they need lose a considerable amount of weight—more than most people can sustainably drop with diet and exercise alone. In the course of their study, the participants received either one or both types of bariatric surgeries between 2004-2017. 66% of them received gastric bypass (which divides the stomach in two small pouches) and 34% had gastric sleeves. This is a surgery that removes about 80% from the stomach and leaves a bit the size of a banana. Gastric Sleeve procedures are now more popular in America, representing 65% to 70% percent of all bariatric surgery. These surgeries can be used to help individuals lose 20 to 25% of their weight. The researchers believe this is the threshold that will allow them to reap the benefits with regard to cancer risk. Medtronic provides devices for bariatric surgeries and grants to Aminian as well as several others. The company did not participate in this research. JAMA study.)

“I want more primary care physicians to have serious conversations with their patients about the consequences of obesity and the reversibility of the morbidity and mortality associated with obesity,” says Nissen. “The primary care physician can start the conversation with their patients to consider surgery and determine if they are eligible.”

In a variety of ways, obesity may increase cancer risk. Studies have shown that fat cells aren’t inert, but very metabolically active. They make substances that contribute to inflammation in the liver, which “creates a toxic environment that can increase the risk of cancer,” says Aminian. A woman’s risk of developing breast or uterine cancer can be increased by being overweight. In fact, the study found that endometrial cancer was among the diseases most closely associated with obesity, and that bariatric surgery reduced risk of endometrial cancer by 53%—more than any other type of cancer analyzed in the study.

Although surgery and dramatic weight loss were found to be associated with significant cancer reductions, Nissen, Aminian and others acknowledge that almost 42% of Americans now qualify as obese. This means that surgery isn’t an affordable option. Some people may not be eligible for invasive surgery. This involves major changes to the digestive system. Diet and exercise alone generally do not result in weight loss as significant as the type seen in the study, primarily because it’s challenging for people to adhere to the strict regimens required for continued weight loss.

Several weight-loss medications have recently been approved by the U.S. Food and Drug Administration that could lead to significant enough weight loss, similar to that achieve from surgery, but they aren’t being widely used yet as a tool to combat obesity. Eli Lilly sponsors a study with Nissen that involves 15,000 people. It is an Eli Lilly drug, Tirzepatide. This medication is used to treat obesity in Type 2 diabetics. The study may give primary care physicians more confidence to assist their patients in weight loss strategies, and prevent them from developing cancer.

“One tool is in the hands of surgeons, and now there are tools in the hands of non-surgeons [in the form of drug treatments,]” says Nissen. “Between these two strategies, I actually think there may be light at the end of the tunnel.”

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