Navigation Links
Obesity and diabetes have adverse effects on cancer outcomes
Date:3/20/2014

Both obesity and diabetes have adverse effects on outcomes in breast cancer patients who receive chemotherapy as primary treatment before surgery (neoadjuvant chemotherapy), according to research to be presented at the 9th European Breast Cancer Conference (EBCC-9) tomorrow (Friday). Although a high body mass index (BMI) is known to have a negative impact on cancer development and prognosis, until now there has been uncertainty as to whether having a high BMI had an equal effect on patients with different types of breast tumours.

Dr Caterina Fontanella, MD, a trainee in medical oncology from the University of Udine (Italy) and a research fellow with the German Breast Group, based in Neu-Isenburg, near Frankfurt am Main (Germany), will present an analysis based on nearly 11,000 patients with early breast cancer treated with neoadjuvant chemotherapy. She will show that a high BMI adversely affects the chances of surviving without the breast cancer recurring or spreading to other parts of the body, , although this detriment was not seen in those women had been diagnosed with HER2-positive disease.

"Although the overall survival of patients with metastatic breast cancer has increased over the past few decades, it remains an incurable disease," Dr Fontanella will say. "So preventing disease relapse after primary treatment of early breast cancer is fundamentally important in oncology daily practice. Considering that about one-third of the worldwide population has a body mass index higher than 25 kg/m, investigating the possible higher risk of relapse that affects overweight and obese patients compared with normal weight patients should be a priority."

The researchers studied data from 8,872 early breast cancer patients from the German Breast Group, and 1,855 from a joint EORTC/BIG[1] trial. All had received a modern treatment consisting of an anthracycline/taxane-based neoadjuvant chemotherapy, anti-HER-2 drugs, or hormone therapy according to tumour type and national guidelines.

The vast majority of the patients in this study received chemotherapy doses capped at a body surface area (BSA) of 2.0m, which is often the limit when calculating doses. "Obese patients may have a BSA of more 2.0m, but the chemotherapy dose they receive will not reflect this. It is a very common practice in these patients for fear of overdosing, but of course it means that they will often receive a relatively lower quantity of chemotherapy," Dr Fontanella will say. "In my opinion, a deeper understanding of chemotherapy metabolism and distribution in patients with high BMI and with increased adipose tissue is needed."

"We already know that obese hormone receptor-positive tumour patients respond less well to aromatase inhibitors as adjuvant treatment, and this underlines a key role of higher aromatase activity in patients with increased adipose tissue." Aromatase is an enzyme that synthesises oestrogen, and blocking it is important in cancers where oestrogen encourages tumours to grow.

Final analysis of outcomes from the two groups in the joint study showed a significant decrease in survival without the cancer spreading (metastasising) distant disease-free survival (DDFS) or the cancer recurring distant relapse-free survival (DRFS) in patients with increased BMI in all tumour types, apart from those with HER2-positive tumours.

"The exception in this group can probably be explained by the impressive impact of anti-HER2 treatment," Dr Fontanella will say. "Given the significant proportion of the world's population with a BMI higher than recommended for good health, it is vitally important that we find a way to treat overweight and obese cancer patients that combines maximum efficacy with the avoidance of unnecessary side-effects."

In a second study, Dr Fontanella and colleagues investigated the incidence of Type 2 (adult onset) diabetes in patients with early breast cancer at the time of diagnosis, as well as its effect on the outcome after neoadjuvant chemotherapy. Diabetes has been reported in 15%-20% of elderly breast cancer patients, although in the group of just over 4,000 patients studied it was considerably lower. "This was probably because these patients were enrolled in clinical trials and were therefore selected to be in good physical condition without other illnesses that could complicate procedures and outcomes," Dr Fontanella will say.

"However, we did find that patients with diabetes were more likely to have their cancer diagnosed at a more advanced stage, and this suggests that diabetes may affect the size of the tumour. We also found that patients with diabetes had worse distant disease free survival rates."

Diabetes is currently believed to be associated with a 49% increased risk of death from all causes in breast cancer patients, as well as being an independent prognostic factor for the risk of recurrence and metastasis. Increased insulin levels seem to be related to a high risk of recurrence after primary treatment, and an increase in C-peptide [2] levels has been associated with an increased risk of cancer-related deaths, particularly in hormone receptor-positive tumours.

"We think that hyperinsulinemia where there are increased levels of insulin circulating in the blood may encourage the growth of tumour cells by providing them with large amounts of glucose. We therefore believe that strict control of blood sugar levels is essential to the successful treatment of breast cancer," she will conclude.

Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), who is a member of the EBCC-9 executive scientific committee, commented: "The growing epidemic of obesity needs to be given greater attention as a risk factor for developing breast cancer, and in how we treat patients in routine practice. The data presented by Dr Fontanella are important as they challenge not only the concept of 'chemotherapy dose capping' but also highlight how much we need to learn about the interaction between obesity and the biology of breast cancer."


'/>"/>
Contact: Mary Rice
mary.rice@riceconseil.eu
ECCO-the European CanCer Organisation
Source:Eurekalert

Related medicine news :

1. Many parents have infant-feeding, TV, and activity practices which may increase obesity risk
2. Child obesity: Cues and donts
3. Cars, computers, TVs spark obesity in developing countries
4. New evidence shows increase in obesity may be slowing, but not by much
5. Obesity treatment using stem cells is the topic of 2013s most-visited news release on EurekAlert!
6. Obesity in men could dictate future colon screenings
7. Tighter economic regulation needed to reverse obesity epidemic -- study
8. Could you relationship with your mom increase your childs chances of obesity?
9. Obesity-induced fatty liver disease reversed in mice
10. Labeling obesity as a disease may have psychological costs
11. Better eating habits, not bad economy, stabilized obesity rates
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... Brooklyn, NY (PRWEB) , ... June 27, 2016 ... ... is using cutting edge technology to revolutionize the emergency ambulance transport experience for ... Many are aware of how Uber has disrupted the taxi industry through the ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media ... give their videos a whole new perspective by using the title layers in ... Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the American Institutes ... Research Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , ... advance care planning, healthcare costs and patient and family engagement. , AIR researchers ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency ... named Dr. Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. ... Director of our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the ... In terms of the latter, setting the bar too high can result in disappointment, ... just slow progress toward their goal. , Research from PsychTests.com reveals ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 ... Market by Type (Standard Pen Needles, Safety Pen Needles), ... (Insulin, GLP-1, Growth Hormone), Mode of Purchase (Retail, Non-Retail) ... MarketsandMarkets, This report studies the market for the forecast ... to reach USD 2.81 Billion by 2021 from USD ...
(Date:6/24/2016)...  Arkis BioSciences, a leading innovator in the ... cerebrospinal fluid treatments, today announced it has secured ... led by Innova Memphis, followed by Angel Capital ... Arkis, new financing will accelerate the commercialization of ... of its in-licensed Endexo® technology. ...
(Date:6/23/2016)... 23, 2016 Any dentist who has made an ... current process. Many of them do not even offer this ... and high laboratory costs involved. And those who ARE able ... such a high cost that the majority of today,s patients ... Parsa Zadeh , founder of Dental Evolutions Inc. and ...
Breaking Medicine Technology: