The evidence that associates obesity and cancer, two of the most important health problems today, are increasing. The relationship has already been demonstrated in the case of breast, uterine, endometrial, colorectal, kidney, esophageal, pancreas, gallbladder, head and neck and prostate cancer; a list to which we must add another: the thyroid cancer of epithelial lineage (it is the most frequent, not hereditary).
According to the American Society of Clinical Oncology (ASCO), there are several reasons that explain why overweight and obesity could contribute to increased cancer risk and development. First, this relationship is mediated by the increase in insulin levels and insulin growth factor type 1 (IGF-1, related to aging) exerted by overweight. In addition, they also influence the low-level chronic inflammation that is more common in people with obesity and the higher amounts of estrogen produced by fatty tissue.
On the other hand, the fact that fat cells can affect the processes that regulate the growth of cancer cells also influences.
The relationship between cancer and obesity has already been the subject this year of a campaign of the NGO Cancer Research UK , dedicated to research and awareness about cancer in the United Kingdom, which highlights that there are more types of cancers caused by obesity than by habit smoking
Recently, an interdisciplinary team of the Biomedical Research Institute of the Hospital de la Santa Creu and Sant Pau , in Barcelona (IBB Sant Pau) has published an article in the journal Scientific Reports that relates thyroid cancer of epithelial lineage to LDL cholesterol (popularly known as the bad one) and one of its main metabolites, 27-hydroxycholesterol (27HC), with its growth and aggressiveness.
Specifically, it has shown that thyroid tumor cells proliferate faster in cultures that contain LDL cholesterol than in their absence, due to their subsequent transformation into 27HC inside those cells. In vitro studies were corroborated in human thyroid epithelial cancer tissues, where there was a direct association between the aggressiveness of the tumor and a decrease in the gene expression of the main enzyme that eliminates the 27HC molecule, CYP7B1.
If the hypothesis we handle is correct, says Eugènia Mato, a researcher at CiberBBN (Center for Biomedical Research in Bioengineering, Biomaterials and Nanomedicine Network) and the research group on Endocrinology, Diabetes and Nutrition of IIB Sant Pau, and co-author of that work , "Cholesterol and some of its metabolites could be considered new therapeutic targets in poor prognosis thyroid tumors."
In the investigation, initiated four years ago, scientists from other groups of IIB Sant Pau participate: endocrinology, diabetes and nutrition; metabolic bases of cardiovascular risk; general and digestive surgery; clinical research in oncology, and molecular pathology of cancer.
Teresa Ramón y Cajal, a medical oncologist specializing in endocrine tumors at the Hospital de Sant Pau and also a member of that interdisciplinary team, explains, on the other hand, that "data on the influence of obesity on cancer survival, mostly from studies of patients diagnosed with breast, prostate or colorectal cancer, show that it can increase the risk of complications of surgical treatment, the risk of recurrence and influence the evolution and prognosis of the disease "
As an example, he cites that obesity " increases the risk of complications from chemotherapy, lymphedema in patients with breast cancer and incontinence in patients treated with radical prostatectomy. In addition, men affected by stage II and III rectal cancer have more risk of local recurrence, and patients with breast cancer and myeloma, worse overall survival due to all causes. "
In this sense, Ramón y Cajal stresses that "maintaining an adequate weight is a protective or reducing risk factor for cancer, which is established as a preventive intervention in the context of public health. Additionally, in the clinical oncological practice this information is incorporated into the oncologist-patient dialogue, which insists on the dietary management of dyslipidemia, physical activity is encouraged and urges to follow the Mediterranean diet model. "
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