Weight-loss surgery may reduce women’s risk of cancer.

Weight-loss surgery may reduce women's risk of cancer.

Bariatric Surgery: A Promising Path to Cancer Prevention and Detection

Obesity and Cancer

It’s no secret that obesity is linked to an increased risk of cancer. However, can weight loss achieved through bariatric surgery help reduce this risk? Researchers have finally had the opportunity to explore this connection, with a study spanning 40 years of follow-up providing confirmation that weight-loss surgery can indeed lower long-term cancer risks, particularly in women[^1^].

Lead researcher Ted Adams, a professor in internal medicine at the University of Utah School of Medicine, explains, “Certainly, there’s evidence that bariatric surgery, which does result in significant weight loss and sustained weight loss, does reduce the risk for cancer”[^1^]. While this study doesn’t pinpoint the exact mechanisms behind this risk reduction, it offers intriguing insights.

One possible mechanism is hormonal. Female-related cancers, such as uterine, ovarian, and breast cancer, showed a significant decrease in bariatric surgery patients compared to non-surgery patients[^1^]. Estrogen, a hormone primarily produced by the ovaries, is a potential driver behind this link. In individuals who are obese, excess estrogen is present due to fat tissues[^1^]. Removing these fat tissues through weight loss could potentially lower the conversion of estrogen and thereby reduce the risk of these cancers[^1^].

Another hormone affected by weight loss is insulin. Insulin levels decrease when people shed pounds[^1^]. However, it’s worth noting that colon cancer, which is not hormone-driven, also saw a reduction in risk. This finding may be attributed to the decrease in body fat resulting from weight loss[^1^].

To study the effects of bariatric surgery on cancer risk, researchers performed a retrospective analysis, comparing more than 22,000 bariatric surgery patients with obese patients who did not undergo surgery[^1^]. This comparison involved considering obesity- and non-obesity-related cancers, as well as gender, cancer stage, and the specific surgical procedure[^1^]. The results showed that the surgery group had a 25% lower risk of developing any cancers, while female patients had a remarkable 41% lower risk of developing obesity-related cancers[^1^]. Unfortunately, male bariatric surgery patients did not exhibit a lower cancer risk[^1^].

The cancers that displayed significant reduction in risk were uterine, ovarian, colon, as well as pre- and post-menopausal breast cancer[^1^]. Additionally, these cancers were detected at earlier stages in bariatric surgery patients, which further underlines the importance of considering surgery as a preventive measure[^1^].

The study’s findings prompt a valuable message for both patients and healthcare providers: a comprehensive discussion is essential to evaluate the pros and cons of bariatric surgery, based on the individual’s health and well-being[^1^]. Dr. Adams emphasizes, “I think a unique point to this study is that not only did we show cancer prevention in terms of reducing the risk of developing cancer, but it also appears to be cancer being detected at earlier stages”[^1^].

Although this study provides compelling evidence, more research is needed to unravel the precise reasons why bariatric surgery plays a significant role in cancer prevention[^1^]. Weight loss alone may not be the sole factor; other surgical impacts, such as alterations to the intestinal tract, might influence the release of hormones and contribute to this preventive effect[^1^].

While the study has its strengths, including a significant number of patients and long-term follow-up, it’s crucial to acknowledge its limitations. Dr. Christina Annunziata, the senior vice president for extramural discovery science at the American Cancer Society, highlights that the study is retrospective, potentially leading to unbalanced populations in the surgery and non-surgery groups[^1^]. To address this concern, randomized trials and comparative studies could shed further light on the impact of bariatric surgery on cancer prevention and detection. These trials could also explore the potential benefits of new weight-loss therapies, like Ozempic, which require more long-term research[^1^].

In summary, bariatric surgery holds promise as a viable path for reducing cancer risk and facilitating earlier cancer detection. With its significant impact on weight loss and sustained results, this surgical intervention demonstrates potential benefits, especially for women and specific cancer types. However, it’s important to consider individual health conditions and undergo comprehensive discussions with healthcare providers to make informed decisions regarding bariatric surgery.

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Sources: 1. Ted Adams, PhD, MPH, Intermountain Surgical Specialties/Digestive Health Clinical Program, University of Utah School of Medicine, Salt Lake City 2. Christina Annunziata, MD, PhD, senior vice president, extramural discovery science, American Cancer Society 3. Obesity, Aug. 22, 2023