Obesity is the harbinger of many diseases. One of them is “cancer”, the emperor of all maladies. There is increasing evidence that obesity is a risk factor for developing many types of cancers. Obese women are more prone to developing certain gynaecologic and breast cancers as compared to normal weight women.
Problems don’t end here as obese women with cancer also have a lower rate of survival due to late detection, associated illnesses like type 2 diabetes, high blood pressure, heart disease etc and sometimes, poorer response to treatment. They also tend to have higher complication rates after surgery for cancer and there is still lack of consensus on suitable dosages of chemotherapy agents for obese patients.
Some of the cancers in women that are linked to obesity are as under:
Endometrial cancer has a strong correlation with obesity. 40% of endometrial cancer of uterus happens in obese women. In women who are pre-menopausal and have PCOD, the uterine endometrium is chronically exposed to estrogen. This leads to thickening of the uterine endometrium and some-times this may undergo cancerous changes. On the other hand, in women who are pre-menopausal and post-menopausal, insulin and androgen levels are increased. These also lead to more unregulated availability of estrogen which eventually leads to endometrial proliferation and eventually cancer.
Obesity is a state where estrogen levels are increased significantly. Due to this reason, obese women tend to develop cervical adenocarcinoma. Obese women also tend to put off cervical cancer screening in the form of PAP smear. This is usually due to poor body image, embarrassment and discomfort. Delayed diagnosis is commonly observed. It is recommended that obese women must also have a PAP smear at the same frequency as their normal weight counterparts.
The link between obesity and breast cancer in post-menopausal women is well-established. This is said to be due to high estrogen levels in obese women. It is said that this risk is even higher than women who are on hormone replacement therapy. Women who are obese tend to suffer more complications after breast cancer surgery and have increased morbidity. They also tend to have a higher recurrence rate as well as an increased risk of developing cancer in the other breast.
One of the reasons for a poorer outcome of breast cancer in obese women is due to delayed detection. A lot of obese women do not feel comfortable with their body image and hesitate to undergo routine screening mammography. Breast cancer also tends to be more aggressive in this group of women and there is a higher chance of the cancer spreading to other organs.
Unopposed estrogen levels may pre-dispose obese women to develop ovarian cancers. However, the data on this is inconclusive about a possible association
With rising levels of obesity, the incidence of these cancers is also rising among women. Prevention of obesity is a must and goes a long way in reducing the incidence of breast, endometrial and cervical cancer in women. Obesity has a very far reaching effect on women’s health and they must be regularly counselled to follow a healthy lifestyle and prevent weight gain. Last but not the least, take care of your body, it is the only place you have to live in.
Dr. Aparna Govil Bhasker