Bariatrics as cancer prevention
Overweight surgery reduces the chances of getting cancer
Overweight is a serious medical problem: obesity is associated with an increased risk of developing pathology of the cardiovascular system, diabetes mellitus, cholelithiasis, arthritis and other diseases, including cancer. Recently, scientists have found out whether it is possible to reduce the risk of getting cancer associated with obesity as a result of bariatric surgery on the digestive organs
Article by Aminian et al. The Association of Bariatric Surgery With Cancer Risk and Mortality in Adults With Obesity is published in the Journal of the American Medical Association.
Experts associate the development of 7-13 different types of cancer with obesity. First of all, these are tumors of the endometrium (the body of the uterus) and ovaries, postmenopausal cancer of the breast, pancreas and thyroid glands, as well as the colon and liver. According to the American Cancer Society, as a preventable cause of cancer, obesity is second only to tobacco smoking. But is it possible to reduce the risks if you "lose" weight, or does any serious set of extra pounds cause irreparable harm to the body?
To clarify this issue, American researchers analyzed the data obtained in a retrospective study of SPLENDID, which involved more than 30 thousand adult obese patients observed at the Cleveland Clinic (USA). From 2004 to 2017, 5 thousand of these patients underwent bariatric surgery that promotes weight loss.
Bariatric surgery is a surgical intervention on the digestive organs. At the Cleveland Clinic, it was a gastroshunt, or gastric bypass surgery (during this operation, a "small stomach" with a volume of about 80 ml is formed, from which food immediately enters the small intestine) or a sleeve gastrectomy, during which part of the stomach is removed.
As a result of bariatric operations, the patient's body weight is usually reduced by 20-35% due to rapid saturation and a decrease in the amount of food intake, and this effect persists for many years. According to some estimates, bariatrics is the most effective method of treating obesity and the only method that can provide such a large and persistent weight loss. So, within 10 years after the operation, patients from the bariatric surgery group lost an average of 27.5 kg, and from the control group – an order of magnitude less.
Over the same 10 years, only 2.9% of patients who underwent bariatric intervention developed cancer associated with obesity, and 0.8% of patients died of cancer. The corresponding figures for the control group are 4.9 and 1.4%. Thus, the weight loss achieved through surgery reduced the risk of developing cancer by 32%, and the mortality from it by almost half.
The probability of getting cancer types associated with obesity within ten years after surgery, depending on the weight lost. Figure from the article by Aminian et al.
It should be added that the mechanisms mediating the link between obesity and cancer are not fully understood. It is assumed that the main role in this may be played by chronic inflammation provoked by excess weight, as well as increased release of sex hormones, and increased resistance to the hormone insulin, which regulates carbohydrate metabolism. Accordingly, so far nothing can be said about the mechanisms responsible for reducing cancer risk after significant weight loss.
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