cancer and fat

From: Dennis Fantoni (df@image.dk)
Date: Thu Apr 24 2003 - 02:46:24 MDT

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    This one hit the wires about 3 minutes ago

    NEW ORLEANS, Apr 24, 2003 (AP WorldStream via COMTEX) -- Losing weight could
    prevent one of every six cancer deaths in the United States - more than 90,000
    each year, according to a sweeping study that experts say links fat and cancer
    more convincingly than ever before.
     
    Researchers spent 16 years evaluating 900,000 people who were cancer-free when
    the study began in 1982. They concluded that excess weight may account for 14
    percent of all cancer deaths in men and 20 percent of those in women.
     
    The study was big enough to back up a fat connection not only in cancers where
    it has been known for some time, but in eight where it hadn't been widely
    documented, lead researcher Eugenia Calle said.
     
    Calle, whose study is in Thursday's New England Journal of Medicine, said she
    was surprised the link "really was the rule more than the exception."
     
    A commentary said the study is 10 times greater than the largest previous
    research on the topic. Top researchers in both cancer and obesity said the
    research virtually proves they are linked.
     
    "Because of the magnitude and strength of the study, it's irrefutable," said Dr.
    Donna Ryan, head of clinical research at the Pennington Biomedical Research
    Center in Baton Rouge. "It's absolutely convincing. And therefore it's
    frightening."
     
    Dr. Robert Mayer of Harvard Medical School and the Dana Farber Cancer Institute
    in Boston said it's not certain whether one in five, six or seven cancers might
    be prevented or better treated if people lost weight.
     
    "What's clear is that large studies of this sort - and this is the biggest and
    best to date - show very clearly this is a major health problem in this
    country," said Mayer, speaking for the American Society of Clinical Oncology.
     
    The study by American Cancer Society relied on the body mass index using heights
    and weights reported by study participants. For instance, a 5-foot-11 (1.80-cm)
    person who weighs 175 pounds (79 kilograms) would have a BMI of 24.4, near the
    top of the normal range. A 5-foot-3 (1.60-meter), 175-pounder (79 kilograms)
    would be obese, with a BMI of 31.
     
    For the study, a BMI of 18.5 to 24.9 was considered normal. Those who were
    overweight (25 to 29.9) or obese (30 or over were all compared to the normal
    group, and statistical analysis was used to adjust for smoking and other risk
    factors.
     
    Earlier studies have found that excess weight contributes to cancers of the
    breast and uterus, colon and rectum, kidney, esophagus and gall bladder. This
    one also linked it to cancers of the cervix and ovary, multiple myeloma,
    non-Hodgkins lymphoma, pancreas, liver, and, in men, the stomach and prostate.
     
    The researchers found no link between fat and brain, skin and bladder cancers.
     
    There are two big reasons the overall link is stronger in women than in men,
    Calle said.
     
    "More women are obese," she said. "And also, breast cancer plays a pretty big
    role here. That's obviously one of the most common cancers."
     
    Too much body fat can influence cancer and cancer mortality a number of ways. It
    increases the amount of estrogen in the blood, increasing the risk of cancers of
    the female reproductive system. It increases the risk of acid reflux, which can
    cause cancer of the esophagus. It raises levels of insulin, prompting the body
    to create a hormone which causes cells to multiply.
     
    Obesity also makes cancer harder to diagnose and treat. It's harder to see or
    feel lumps and bumps, and some patients don't fit into CAT scanners, Mayer said.
     
    They also may avoid regular doctor's visits, "possibly because of their
    appearance or they just shy away from physicians," he said.
     
    "The morbidly obese are harder to operate on, harder to plan radiation therapy
    for - often, they don't even fit into a radiation therapy machine," Mayer said.
    He said it also is hard to decide the right chemotherapy dose for the obese,
    because fat tissue sometimes absorbs the chemicals.

    Dennis



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