5 things your doctor wants you to know about cancer and obesity

Healthcare providers are learning more and more about the connection between cancer and our everyday health. For example, did you know that roughly 4­ to 8 percent of cancers can be directly attributed to obesity? This includes such cancers as colorectal, esophageal, kidney, liver, gallbladder, pancreatic, breast and uterine cancer.

Dr. Justin Grannell, Beacon Medical Group Bristol

“This can be a very sensitive subject when talking with patients,” said Justin Grannell, DO, a family medicine physician with Beacon Medical Group Bristol. “It is important to approach this with empathy to show patients that we truly care about their well-being.”

While we don’t yet understand all the links between cancer and excess weight, there are some key health facts that physicians want you to know. Here are five of the most important things to understand about this connection.

Body fat is active, living tissue. We tend to think of fat as just sitting there, not really doing anything other than taking up space. In reality, fatty tissue releases enzymes, hormones and chemicals that create a cancer-friendly environment in your body.

For example, fatty tissues can produce too much estrogen, which has been associated with breast and other cancers. Likewise, obesity tends to go hand-in-hand with insulin resistance that has been linked to a higher risk of colon, prostate, kidney and endometrial cancers.

The location of fat deposits matters, too. Visceral fat (fat around the organs) carries different – and usually higher – risks than subcutaneous fat (fat around the hips and thighs). Think of the classic apple versus pear body shapes, with the apple shape being at higher risk.

Obesity appears to influence not only the risk of getting cancer, but the risk of cancer coming back after treatment and the likelihood of dying from cancer.

Specific risks seem to be different for different types of cancer, and the links are still being researched. It is believed that chronic inflammation and obesity-related changes in hormones, the immune system and gut bacteria contribute to the development of cancer, as well as its progression in the body. Higher blood sugars could also be a factor.

The chance of cancer being diagnosed and recurring seems to be higher with the most common cancers, including colorectal, breast and prostate cancers.

Interestingly, people who are obese have a better chance of surviving lung, kidney and skin cancers – but these are the exceptions to the rule.

The side effects from cancer treatments can be worse for people who are obese. These side effects may range from surgical complications to radiation-related skin problems.

Sometime this is a structural issue – for example, fatty tissues tend to move around more than other tissues, so it can be more difficult for doctors to precisely target radiation therapy.

Other side effects may be linked to chemical changes in the body. For example, diabetes certainly has an effect on healing.

Medical experts are still trying to understand the effect of obesity on other side effects, such as lymphedema, a condition in which excess fluid causes swelling. The risk for lymphedema is nearly three times higher in women with breast cancer who are obese.

Lifestyle changes make a difference. The good news about the effect of lifestyle on cancer risk is that it gives you an opportunity to take action to reduce that risk.

People who are obese can lower their risk of developing and dying of cancer by exercising more, eating a low-carbohydrate diet and losing weight.

Not only do such lifestyle changes tend to reduce weight, but they also improve your health overall. Giving your body higher-quality fuel in the form of a well-balanced diet helps your immune system and supports healthy gut bacteria. And more movement every day has huge health benefits beyond cancer prevention.

Get the cancer screenings your doctor recommends. Although there are general guidelines for when and how often to get screenings, it really depends on your family history and personal risk factors. Your doctor will take these into account when recommending which screenings you should have, and how often to get them.

“There is no doubt about the link between obesity and increased cancer rates, which makes screening even more important,” said Dr. Grannell.

“I find that a lot of patients shy away from screening, as they may have had a family member or friends go through chemotherapy or other invasive measures that they themselves have decided they would never put themselves through,” he said. “I think it’s very important to talk with patients about the importance of screening – not to find cancers in their late stage but in their early stages so that more extreme measures are not needed. I find that this often convinces patients to go ahead and proceed with these screening tests.”

Remember: Whatever your weight, body shape or health risks, the earlier cancer is detected, the better.

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