Obesity and Cancer

As probably all of you know, cancer is one of the leading causes of mortality in obese patients, on the other hand treating obesity (at least with bariatric surgery) is associated with a 40-60% reduction in cancer mortality (see the Sjostrom et al. and Adams et al. studies recently published in the NEJM).

I had several conversations/contacts last week about this:

1) Vickie Baracos UofA’s Alberta Cancer Foundation Chair in Palliative Medicine, told me about some fascinating data they were collecting on obesity in their cancer patients, hundreds of MRI and CT images were currently being analysed.

2) I learnt that Dr. Tanis Mihalynuk and colleagues from the Alberta Cancer Board were just embarking on an asset mapping exercise regarding community resources on obesity prevention.

3) I also received an e-mail from Dr. Heather Bryant, Vice President & C.I.O., Alberta Cancer Board, Director Division of Population Health & Information, who would like to meet with me on Oct. 9 to discuss the prevention or reduction of obesity which is seen as central to achieving a reduction in cancer incidence.

All of this is very much in line with my own ideas on linking Weight Wise to the Cancer Board activities.

I think we need to develop and implement collaborations with the Alberta Cancer Board and the relevant CH Cancer Services and Programs to:

– recognize the incidence and prevalence of excess weight in cancer patients

– provide information, education and support to cancer patients at risk for weight gain

– provide weight-management services to cancer patients with excess weight

– coordinate cancer screening and treatment services for patients with excess weight seen in the bariatric clinics

Measures of these activities in the area of cancer can include information on the following:

– No. of cancer patients receiving information, education and support to prevent excess weight gain

– No. of cancer patients receiving services for excess weight

– No. of bariatric patients receiving cancer screening and treatment services

There is no question that obesity is a widely ignored issue in cancer patients, both as a risk factor and as a problem following cancer treatments. The increased weight gain seen in some chemotherapy patients is well described, but poorly understood.

As always, I look forward to thoughts and comments,