Researchers at the University of California, Moores Cancer Center, and San Diego School of Medicine found in their recent study that bariatric surgery where dramatic weight loss occurs in severely obese women reduced their risk of uterine or endometrial cancer by nearly 71% and as much as 81% if normal weight was maintained following surgery. These findings were published in the April Issue of Gynecologic Oncology, the Society of Gynecological Oncology’s official publication.
These findings show how obesity may be identifiable and modifiable risk factors for endometrial cancer and that bariatric surgery could be a viable option for patients. The study looked at nearly 7.4 million patients in the University HealthSystem Consortium database. This database contains information from various academic medical centers in the United States as well as affiliated hospitals. Of this total number of patients, 103,797 patients had a history of bariatric surgery and 44,345 had been diagnosed with uterine malignancies.
It’s no secret that obesity is a widespread public health problem in America with nearly two-thirds of the Adult population considered either overweight or obese. This condition is linked to many heart risks such as diabetes, heart disease, and cancer, especially endometrial cancer.
The study’s first author, Kristy Ward, MD and senior gynecologic oncology fellow in the Department of Reproductive Medicine at UC San Diego School of Medicine said that by looking at studies that looked at increasing BMI and endometrial cancer risk, they found that women with a BMI of 40 or more were at an eight times greater risk of a uterine cancer diagnosis than someone with a BMI of 25. She noted that the risk continued to rise as the BMI rose as well.
Ultimately, patients qualify with a BMI of 40 or more or a BMI of 35 or more with two co-morbidities such as joint disease, diabetes, sleep apnea, heart muscle disease and more. During bariatric surgery, the stomach is reduced with a constrictive gastric band that removes a part of the stomach by either resecting or re-routing the small intestines to make a small pouch. Surgery must be followed up with lifestyle changes to make sure that weight loss remains successful.
Many other mechanism link obesity to endometrial cancer directly. Excessive fat tissue raises levels of estrogen in the body which are known to create tumors or metastasis in women. Most endometrial cancers are estrogen-driven, which means that menstruating women that have both estrogen and progesterone in their endometrium or who have excessive fat tissue in their body will have a higher level of estrogen leading to an increased risk of endometrial cancer.
When there is too much estrogen which causes the endometrium to build up, there is not enough progesterone to stabilize the levels. The endometrium continues to grow and has abnormal tissue changes which can lead to cancer. Weight loss surgery has been shown to reduce increased hormone levels, to decrease inflammation, drop insulin resistance, and to aid in weight loss and improved health.
The study’s researchers understand that obesity is a complication issue. They believe more studies need to look at how bariatric surgery and cancer prevention and care can be linked.