Weighing heavy on Big C

Having more fat tissue can increase one's chances of getting breast cancer, writes Rashmi Vasudeva

Obesity is considered to be the villain of the story, at least in most people’s minds, when they think of cardiovascular ailments or lifestyle diseases such as diabetes and hypertension. However, not many know or appreciate how much risk this particular villain poses to the big C, especially breast cancer in women of a certain age.

Although most evidence that link obesity to cancer risk are derived from observational studies (that are difficult to interpret and do not conclusively establish connections), there is enough consistency in these studies to say that higher amounts of body fat are definitely a risk factor for a number of cancers, including kidney, colorectal, pancreatic, endometrial and, of course, breast cancer. “Those with a Body Mass Index (BMI) of over 40 are certainly at a greater risk of contracting digestive tract cancers and breast cancer,” confirms Dr Manish Joshi, senior consultant and incharge, department of surgical gastroenterology, BGS Gleneagles Global Hospitals, Bengaluru.

Worrisome

“Obesity is a particularly worrisome risk when it comes to postmenopausal women. Several epidemiological studies have established the link. This is largely due to higher oestrogen levels in women of this age,” informs Dr Santosh Gowda, additional director of medical oncology, Fortis Hospitals, Bengaluru.

The doctor goes on to explain that having more fat tissues in the body raises oestrogen levels, thus increasing the risk. Also, women who are overweight tend to have higher levels of insulin, another hormone that has been linked to some cancers, including breast cancer.

According to the US-based National Institutes of Health (NIH), postmenopausal women who are obese have a 20 to 40% increase in risk of developing breast cancer compared with women of normal weight. The risk has been found to be higher in women who have not used menopausal hormone therapy. A meta-analysis of 34 studies that examined more than 2.5 million women, including 23,909 postmenopausal breast cancers, indicated that postmenopausal breast cancer risk was positively associated with increase in BMI, informs Dr Monika Pansari, consultant surgical oncologist (breast & gynaec onco surgeon), BGS Gleneagles Global Hospital, Bengaluru.

“A hospital-based study from Mumbai found that obesity is a strong risk for breast cancer among women, irrespective of menopause and with no history of hormone replacement therapy,” adds Dr Ravi Mehrotra, director of Noida-based ICMR-National Institute of Cancer Prevention and Research.

In fact, Dr Mehrotra who has been spreading awareness about obesity-related cancer risks cautions that India is undergoing what he calls a “rapid demographic, health and nutritional transition.”

Lack of awareness

“On the one hand, the country is still fighting a battle against poverty, under-nutrition and communicable diseases, on the other hand, risk factors like rising obesity pose a serious threat. This is worrisome given the link between obesity and breast cancer,” he says. Unlike popular perception, people in rural areas, too, are falling prey to the ‘obesity monster’.

“Unhealthy lifestyle practices, aspirational eating and lack of cancer awareness is proving to be a dangerous combination in India’s hinterlands, and if left unchecked, this could well become an epidemic,” he warns.

Evidently, there is a huge problem at hand. However, all is not lost. “First and foremost, everyone has to do their bit to raise awareness among the public that the health risks associated with obesity include heart disease, stroke, diabetes and hypertension but are not limited to these. Obesity is also a risk for many types of cancer and this cannot be stressed enough,” says Dr Gowda.

The solution, of course, lies not only in spreading awareness about the risks as Dr Gowda says but also in following certain good practices and putting in place preventive measures. Quite the only way to defeat this villain.