Written by Jeff Ruby
Cancer is always an unwelcome surprise. Whether it is a personal diagnosis, or the verdict given to a loved one, those six letters are typically associated with fear, stress and complete disbelief. Cancer is a particularly sensitive subject for me—as it is for so many of us—as I lost my father at a young age to a disease I believe could have been prevented with the right healthy lifestyle. The lessons learned through his unfortunate experience were the catalyst for my passion for prevention and my last four start-ups.
For years, cancer has been the health crisis that appears to come out of nowhere, sometimes affecting an innocent child, other times a young adult, and often an older relative or parent. With rare exception, it leaves a path of physical and emotional devastation for patients, family, and friends alike. Interestingly, and contrary to what most people think, it is estimated that only 5–10% of all cancer cases can be attributed to genetic causation.1 The remaining 90–95% of cases have their roots in the environment and lifestyle.1
This is promising news! It means that as research continues to pour in, more risk factors, which are often modifiable with the right nutrition, exercise, and behavioral well-being, can be identified in providing a clearer understanding of what we can do to reduce our risk and regain our power.
In the 1940’s and 50’s, cigarettes were identified as the cause of the lung cancer epidemic. With education, awareness, and preventative efforts, many of us changed our views on smoking, and as a society we became more responsible by reducing permitted smoking areas and therefore exposure.
Today, epidemiologists from the American Cancer Society are raising the alarm about a new risk factor: obesity. To date, research indicates that obesity contributes to nearly 20-25% of new cancer cases in the U.S.—representing more than 400,000 people—and is associated with a worse prognosis, less effective treatment, and higher risk of secondary malignancies.2,3 When obesity is combined with other behaviors, including a lack of physical activity and poor diet, the newly diagnosed cases rise to nearly 33%—over 550,000 people—and the challenges associated with treatment only worsen.4
To date, not all cancers have been linked to weight; however, the list of those having a strong correlation is high. Thus far, observational studies suggest that people who are obese have a 60% increase in risk of developing gallbladder cancer, a 30% increase of colorectal cancer, and a 50% increase of meningioma and slow growing brain tumors.5 Postmenopausal women who are obese also have a 20-40% increase in risk of developing breast cancer. People who are obese are twice as likely to develop cancers of the kidney, liver, stomach, esophagus, and endometrium.5
Theories related to how obesity may increase cancer incidences are currently being explored. It is clear that obese people have higher blood levels of insulin and insulin-like growth factor-1. Not only do these contribute to the development of type 2 diabetes, high levels may also promote the development of colon, kidney, prostate, and endometrial cancers.5
Higher amounts of fat tissue, and the fact that fat serves as a storage site for hormones, may also shed light on the association of obesity and cancer risk. Estrogen is stored in fat, therefore higher amounts of fat translate to higher amounts of estrogen leading to higher risk of some breast, endometrial, and ovarian cancers.5 Fat cells also produce other hormones such as leptin which seem to promote proliferation (a rapid increase in cell numbers), whereas adiponectin, a different hormone, has anti-proliferative effects, and tends to be less abundant in obese people.5
Inflammation is also an issue, and may explain increased cancer risk. Chronic inflammation is a common concern as it can lead to damage in DNA. Overweight and obese individuals are more likely to suffer from conditions that cause chronic inflammation.5
Despite an awful lot of money being thrown at finding ‘a cure’, cancer rates continue to rise. The increase is because of better screening and detection, along with the fact that we are living longer, with a large percentage of the population now over 60 years of age. However, incidences of cancer are also increasing in relation to rising obesity rates. Nearly 70% of U.S. adults age 20 years or older are considered overweight or obese with more than one third meeting the criteria for obesity. These numbers are staggering and are projected to rise, and with 40% of all cancers now considered obesity-related cancers, you can only imagine the detrimental effects this will have on our personal health and health care costs.
Fortunately, the link between obesity and chronic diseases such as heart disease, stroke, and diabetes is crystal clear. Unfortunately, cancer seems to get left off the list as a disease that can be prevented should we improve our efforts at reducing weight and living healthier everyday. There is ample evidence today on how obesity has an impact on cancer prognosis, severity, and recurrence. Similar to ignoring the effects smoking has on cancer, it would be a shame to ignore the effects obesity has on cancer.
For the sake of the nearly 2 million Americans and their loved ones who will hear the dreaded words “you have CANCER” this year, we can and need to do better. This is within our power to change and improve.