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Obesity may affect cancer patients' outcomes
May 16th, 2014
10:29 AM ET

Obesity may affect cancer patients' outcomes

Scientists know obese people have an increased risk of getting several types of cancer. But a new study suggests being obese also increases the chance that some patients' cancers will come back,  and increases the likelihood that those patients will die from cancer.

The study was released in advance of the 2014 American Society of Clinical Oncology annual meeting, which begins on May 30.

Researchers looked at 80,000 patients in 70 early breast cancer trials and analyzed their body mass index, estrogen receptor, menopause status, cancer recurrence and their prognosis.

They compared women with higher BMIs (over 30) to those with normal BMIs (20-25) over a 10-year period. They found for younger, pre-menopausal women who have early breast cancer, obesity appears to be strongly linked to worse outcomes, including death.

Specifically, women with BMIs over 30 had a 21.5% chance of dying while women with average BMIs had 16.6% chance of dying. This only applied to women with hormone-receptor-positive breast cancer. Researchers found no apparent effect of obesity in women with estrogen-receptor-negative cancer, according to lead study author Hongchao Pan, a researcher at the University of Oxford.

"The findings from this study support current recommendations that women maintain a healthy weight following a diagnosis of breast cancer," Dr. Ruth O'Regan, a Winship Cancer Center oncologist, told CNN in an email.

This study was surprising in its finding about pre-menopausal women, says Susan Neuhausen, a breast cancer researcher at the City of Hope in Duarte, California. She says it "provides information that clinicians may want to more closely monitor pre-menopausal women who are obese at diagnosis."

Neuhausen said it's not clear why this is true in just pre-menopausal women.

Obesity is known to cause inflammation in the body, said Dr. Clifford A. Hudis, president of the American Society of Clinical Oncology. This inflammation may activate CYP19 - the aromatase gene, which is responsible for estrogen conversion. And estrogen is known to fuel cancer growth in hormone-receptor-positive breast cancer.

Hudis said it's remarkable that only about 4% of people doubt the connection between smoking and cancer, yet just 10% of people understand the link between obesity and cancer.  "No matter how we look at it, obesity is looking to replace tobacco as the overall leading factor leading to cancer."


soundoff (17 Responses)
  1. Dizzyd

    Gee, I wonder if a big part of that 'increased risk' is the fact that our culture is so fat-hating that medical personnel are not exempt, treating their fat patients with thinly-veiled contempt (these are FACTS, people!) that makes them not want to go to yet another place they're sneered down on and told it's-all-your-fault-you-deserve-it-lose-weight-and-just-die-fatty, so they don't get either the preventive or follow-up treatment they need to recover. I hope that there will be some medical personnel who will read this and really think about how the irrational hatred of fat people in our society is probably contributing to this problem more than is admitted. (I already know the trolls will be all over this. Unfortunately, it's always 'fatty season' in this country, but this is too important not to say!)

    May 16, 2014 at 11:12 | Report abuse | Reply
    • Jill

      Dizzyd- Interesting point. Patient Profiling the obese could certainly occur.

      This is how people with spine problems feel when we complain of pain- profiled !
      They weren't around when the pain was a 4, then an 8 . After 24 years of enduring growing pain (from a severe whiplash injury) when I say it's a 9/10 , they scoff.
      I have endured, I have been tough – but instead they look at my youth and act like I'm just a complainer.

      May 16, 2014 at 13:20 | Report abuse |
    • wuzzup

      People revere those who overcome hardships and challenges. People loathe those who expect others to overcome their challenges for them...Here, I'm broken. Fix me! The beauty of the human body? Everybody plays from a level playing field... Rich or poor. Black or white. Male or female...We all have equal choices. And, no one can fix us but ourselves. You're mad at health professionals because you believe they have the "power"? They can advise. They can suggest. They can encourage. But, they can't perform what only the human body can fix. That's why they're fat-hating. Think about it for just one moment. If you're so convinced that you're being denied (by medical professionals), why the heck is 2 out of every 3 adults in America, overweight? You think it's a conspiracy??????

      May 16, 2014 at 15:25 | Report abuse |
    • KD

      I find it ironic that you would claim America is a "fat-hating" society, when our meal portions are twice that in any other country...nearly all our meals contain primarily processed foods (tv dinners, microwave meals, etc), and let's not even discuss our unhealthy obsession with fast food. Many are obsessed with body size and exercise, and this can be as unhealthy as a steady diet of high calorie/high fat/low nutrition foods. Everything in moderation. Doctors also advise to eat diets rich in a variety of FRESH fruits and vegetables, and yet most children are exposed to two or three of each, if at all. I must also point out that when a cancer diagnosis is received, the patient receives a plethora of information regarding diet–what foods to eat, foods that help with chemo & it's effects, and even what foods to avoid. Yes, avoid! Because some foods have the potential to harbor bacteria that can be deadly to an already compromised immune system–I have personal, FIRST-HAND experience in this area!! Let's not forget...obesity puts a person at higher risk for hypertension, type 2 diabetes, high cholesterol, heart attack, stroke, gall bladder disease, arthritis, and sleep apnea, to name a few. Try watching a few episodes of TLC's "My 600-lb-life"...

      May 16, 2014 at 16:53 | Report abuse |
    • echo40

      hahahahahahaha... and I thought I've seen every conspiracy theories out there.

      It is not my fault that I have diabetes, it is not my fault that I have high blood pressure, it is not my fault that I can't walk a block without rest. It is because the medical professionals "hate" fat people.

      NO... outside of very few cases, 99% of overweight is caused by overeating and no exercise. people like you will blame everyone else except for yourselves. As soon as someone suggest "lose some weight" you will jump up (I use that term loosely), and shout "why do you hate fat people?".

      I don't even have to go to other website, just about every week, CNN post articles about people who lost 50, 100, 200lbs and live a much healthy and happy life. Instead of blaming other people, why don't you learn from the people who did it? And don't even start to give me those "fat but healthy" junk. out of 300 million Americans, you find 100? 200? people who are outliers, and say "see, they are fat and healthy". Majority of the people who are overweight are unhealthy. Why take the risk?

      Obesity cost America over $300 Billion a year, think about it, if we can eliminate that, maybe the finance of this country will be in a better shape...

      Please, we "fat hater" just made you soo... depressed that you have to go back to eat a whole bucket of ice cream. No... it is not is your fault... we forced you to eat your way out of your depression........

      May 16, 2014 at 17:12 | Report abuse |
    • Jessica

      Hi. I have been overweight all my adult life, and drove myself into Obesity Land in my mid-thirties. I was diagnosed with stage iv breast cancer at 40. Please...I know it hurts and it's hard to hear ~ but it's your Health. Potentially...Your Life.

      Actions beget consequences. It's biology, not conspiracy. AGREED: Doctors do not understand many things about patients. Especially about how their words and tone can hurt. But, being fat DID help give me cancer. Burying my head in the sand about the choices I was making was...my choice. Re-read first sentence of this paragraph knowing "but your outcome isn't pre-written in stone."

      Biological Facts:
      1. Obesity causes inflammation in the body.
      2. Inflammation creates a Fun Playground in the Body for cancer cells to thrive in.
      3. Obesity creates additional hormones in the body.

      Cancer Observations, my own:
      1. Cancer looooves these hormones. I have the estrogen-positive receptors of which the article speaks.
      2. Having Cancer SUCKS. Cancer treatment sucks.
      3. Cancer can be killed through retraining a body to health. In my case, stalled.

      Don't allow hurt feelings to immobilize you from acting upon the message: Being overweight isn't healthy...And Can Kill You.

      Everyone Knows This, internally. Us fat people aren't ignorant to it. But, like quitting an addictive habit, changing what we eat is HARD. There are items in processed food Meant to Addict us. So when we claim "it isn't our fault," well, it isn't...and it is. But choices are choices only if we are educated about them. Learning about how real, whole food fuels health is fascinating ~ and will keep one OUT of Doctor's Offices, if applied.

      Finding true health opens up your life. I believe this. I'm living it, even as I'm living with an "incurable" cancer. It's just better to not need pharmaceuticals to fix side effects caused by carrying more weight than is a body's need.

      Good Luck in your return to your healthy-body state...wherever that is. It's worth the effort ~ NOW. To avoid getting cancer. Cancer's no punch line.

      May 17, 2014 at 09:55 | Report abuse |
    • Bob

      Dizzyd is right in that many clinicians look down upon their clients. The end result is that overweight people who need help then avoid the very people whose job it is to help them. Please research the topic if you don't believe me. There is one woman researcher who is very high up in management at Mass. General Hospital that even claims that if only people became protestants they would get thinner. Seriously. Her belief is that if you make overweight people feel guilty and then teach them to take responsibility, like protestants like her do, they will magically get thin. Great. A researcher claiming to be a scientist using a research paper to promoter her religion. If you don't believe me do your own research on it.

      May 17, 2014 at 12:38 | Report abuse |
    • RM4213

      No.. it is because fat tissue is more than energy storage. It produces pro-inflammatory cytokines and recruits pro-inflammatory immune cells. Too much fat throws your immune system out of balance and contributes to autoimmune diseases and cancer. Sorry to break your bubble of rationalization but obesity is a killer.. it is the worst thing a person can do to themselves and unfortunately it is almost always preventable. Doctors try to help patients the best they can..so it must be really really frustrating for them when the patient is intentional killing themselves with obesity but expects the doctor to make it all better.

      May 18, 2014 at 18:29 | Report abuse |
    • amyhowerton

      I'm a family practice physician. One problem with obesity is that excess weight makes it REALLY difficult if not impossible to feel masses in breasts or the abdomen and to reach the prostate. Even CT scans and x-rays have a harder time "seeing" through the fat tissue. There are people who are over weight and still very healthy (not usually obese and healthy), but any extra weight still makes screening tests more difficult. I hate the way we go about it, making people feel bad about being over weight. BUT, we can't escape the truth that there are some risks to being over weight! Especially when you get there by eating processed foods and sodas etc.

      June 21, 2014 at 13:54 | Report abuse |
  2. Barbara

    There's a lot in the scientific literature supporting a link between obesity and cancer progression

    http://www.ncbi.nlm.nih.gov/pubmed/24829560

    This is a free paper.

    May 16, 2014 at 16:42 | Report abuse | Reply
    • echo40

      Please... the medical profession hate fat people, these papers are just a cover to hide their hatred of fat people.

      May 16, 2014 at 17:16 | Report abuse |
  3. Bob

    According to Stephen Hawking, the Big Bang has led to all events. According to the laws of physics there can be no free will. For a doctor to blame a patient for that patient's medical issue, the doctor must believe in free will. If the doctor proclaims that his/her practice is based on science he must assume there is no free will and that the patient's problem was not the fault of the patient. He/she must instead look for a guiltless, rational solution. Thus, the doctor that blames the patient is not practicing science – the patient may as well go to a faith healer or priest in that case. If doctors are going to base their practice on religion, which is required for the belief in free will, they should tell their patients ahead of time that they are basing their practice on religion, not science.

    May 16, 2014 at 20:14 | Report abuse | Reply
  4. jeremy

    Ok, tell us something we don't already know. We know obesity causes everything. I'm not convinced that there is no cure for cancer anyway. They can cure and control everything from a new heart to making a crazy person totally sane again. Where's the cure for cancer. Maybe they have one. Seems like the stone ages.

    May 17, 2014 at 03:47 | Report abuse | Reply
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    May 18, 2014 at 11:28 | Report abuse | Reply
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    May 18, 2014 at 23:36 | Report abuse | Reply
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    May 22, 2014 at 22:42 | Report abuse | Reply
  8. chrissy

    A big part of the obesity problem is the additives in processed food that werent present 30 years ago or longer! The FDA needs to change up some things that are being allowed today! Too much "corporate america" and not enough focus on the hazzards being unleashed to joe citizen!

    May 23, 2014 at 17:19 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.