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Bariatric Surgery Decreases Cancer Risk in Obese Women

Weight-loss surgery shown to improve quality of life.

In a press release, Dr. Susan Modesitt states that “about a fifth of all cancer deaths would be prevented if we had women at normal body weight in the U.S.” Dr. Modesitt and her colleagues at the University of Virginia Cancer Center seek out to determine the baseline endometrial histology in morbidly obese women undergoing bariatric surgery and to evaluate these women’s serum metabolic parameters, their quality of life (QoL), and weight post-surgical intervention.

71 morbidly obese women, mean age of 44.2 years, with a mean BMI of 50.9 kg/m2 undergoing bariatric surgery were being studied.  Data were collected prior to the surgical intervention and also postoperatively. Endometrial biopsy results showed: “proliferative (13/30; 43%), insufficient (8/30; 27%), secretory (6/30; 20%) and hyperplasia (3/30; 10%-1 complex atypical, 2 simple).” In addition, these patient’s QoL showed significant improvement after surgery (p < 0.001).

Metabolic analysis was done on 20 of the women and was shown that there was a significant improvement in glucose homeostasis, improvement in insulin responsiveness and free fatty acid levels. There was also indications of decreased inflammation and alterations in the intestinal microbiome in these women post-surgery. While most steroid hormones were not significantly impacted, it was shown that there was a decrease of DHEAS and 4-androsten metabolites.

The researchers concluded that bariatric surgery helps to improve physical QoL and also provides “beneficial changes in glucose homeostasis, insulin responsiveness, and inflammation to a greater extent than the hormonal milieu.” The potential cancer protective effects of the surgical intervention might be due to other mechanisms that are involved and not just simply the hormonal changes in these patients post-surgery.

However, patients can help to not put themselves at risk to these cancers by changing their diet and becoming more physically active. Not becoming obese is a much better option for the patients than having the surgery. Moreover, Dr. Modesitt noted that there are many studies that showed that “if you exercise, it improves your insulin, your glucose, all of those sorts of things that go along with the cancer-causing effect” and you will also lose weight.

Practice Pearls:

  • Bariatric surgery helped to improve QoL, glucose homeostasis, insulin responsiveness, and improvement in free fatty acid levels.
  • Bariatric surgery provided a cancer protective effects on these morbidly obese women.
  • A healthy diet and physical exercise is always recommended.

Modesitt SC, Hallowell PT, Slack-Davis JK, et al. Women at extreme risk for obesity-related carcinogenesis: Baseline endometrial pathology and impact of bariatric surgery on weight, metabolic profiles and quality of life. Gynecologic Oncology. 2015 Aug;138(2):238-45. 06 Oct 2015.