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Demi
Thu, Apr-17-08, 00:35
The Telegraph
London, UK
17 April, 2008


Obese women '50pc more likely to die of breast cancer'

Significantly overweight women are almost 50 per cent more likely to die of breast cancer within five years of diagnosis, experts warned yesterday.

Doctors at the 6th European Breast Cancer Conference in Berlin warned that it was more difficult to diagnose the disease in obese patients who also risked getting poorer treatment because doctors feared giving them a high enough dose of chemotherapy for their body weight.

Almost 1,500 patients a year in the UK could be diagnosed earlier if they were not obese, research at the conference suggests. Breast cancer is the most common type of cancer among women, and almost 45,000 cases are diagnosed in the UK every year, around 9,000 in clinically obese patients.

However, that percentage is predicted to increase because of lifestyle factors that have led to a quarter of women being diagnosed as obese.

Obesity has previously been shown to increase the risk of developing the disease, by raising the level of sex hormones such as oestrogen.

Professor Emiel Rutgers, a from the Netherland Cancer Institute and a breast cancer surgeon, said the findings showed "the importance of losing weight, even after you have been diagnosed".

Doctors in Belgium monitored 547 breast cancer patients over five years. They found that those defined as obese, who had a body mass index - weight in kilograms divided by their height in metres squared - of more than 30, were 48 per cent more likely to have died than slim or underweight patients.

Patients who were not obese had an 12 per cent chance of dying within the five years of the study, but that rose to 17 per cent for obese patients, researchers found.

Dr Evandro de Azambuja, from the Jules Bordet Institute, Brussels, who led the study, said that part of the problem was that the majority of obese patients received a standard dose of chemotherapy, which doctors were afraid to increase in line with their height and weight.

Separate research published at the conference showed that obese women were 80 per cent more likely to be in the later stages of the disease by the time they were diagnosed.

Dr Elisabetta Rapiti, from the Geneva Cancer Registry, who led this study, said it was more difficult to diagnose cancer in fatty tissue.

Obese patients also face delays because their weight made them too embarrassed to visit a doctor, she added.

Professor Gordon McVie, editor of ecancer, an online journal, and the former chief executive of Cancer Research UK, said new ways of dealing with breast cancer in obese patients were needed.

He said: "Although we know about the link between breast cancer and obesity, the higher risk of death is surprising. Maybe a new strategy to deal with these patients is needed."


http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/17/nhealth217.xml

LessLiz
Thu, Apr-17-08, 07:58
When you read that article you might want another bit of info.

http://www.cancer.gov/cancertopics/factsheet/Risk/obesity

6. Does obesity increase the risk of breast cancer?

The effect of obesity on breast cancer risk depends on a woman’s menopausal status. Before menopause, obese women have a lower risk of developing breast cancer than do women of a healthy weight (4, 9, 10, 11, 12). However, after menopause, obese women have 1.5 times the risk of women of a healthy weight (9, 10, 13, 14).

Obese women are also at increased risk of dying from breast cancer after menopause compared with lean women (4, 11, 15, 16). Scientists estimate that about 11,000 to 18,000 deaths per year from breast cancer in U.S. women over age 50 might be avoided if women could maintain a BMI under 25 throughout their adult lives (16).

Obesity seems to increase the risk of breast cancer only among postmenopausal women who do not use menopausal hormones. Among women who use menopausal hormones, there is no significant difference in breast cancer risk between obese women and women of a healthy weight (4, 9, 11, 17).

Both the increased risk of developing breast cancer and dying from it after menopause are believed to be due to increased levels of estrogen in obese women (18). Before menopause, the ovaries are the primary source of estrogen. However, estrogen is also produced in fat tissue and, after menopause, when the ovaries stop producing hormones, fat tissue becomes the most important estrogen source (14). Estrogen levels in postmenopausal women are 50 to 100 percent higher among heavy versus lean women (11). Estrogen-sensitive tissues are therefore exposed to more estrogen stimulation in heavy women, leading to a more rapid growth of estrogen-responsive breast tumors.

Another factor related to the higher breast cancer death rates in obese women is that breast cancer is more likely to be detected at a later stage in obese women than in lean women. This is because the detection of a breast tumor is more difficult in obese versus lean women (12).

Studies of obesity and breast cancer in minority women in the United States have been limited. There is some evidence that, among African American women, the risk associated with obesity may be absent or less than that of other populations (19, 20, 21). However, a recent report showed that African American women who have a high BMI are more likely to have an advanced stage of breast cancer at diagnosis (22). Another report showed that obese Hispanic white women were twice as likely to develop breast cancer as non-obese Hispanics, but the researchers did not detect a difference in risk for obese Hispanic women before and after menopause (23).

Weight gain during adulthood has been found to be the most consistent and strongest predictor of breast cancer risk in studies in which it has been examined (4, 10, 11, 24).

The distribution of body fat may also affect breast cancer risk. Women with a large amount of abdominal fat have a greater breast cancer risk than those whose fat is distributed over the hips, buttocks, and lower extremities (13, 25, 26). Results from studies on the effect of abdominal fat are much less consistent than studies on weight gain or BMI.

LarryAJ
Thu, Apr-17-08, 08:54
Here are some more studies on the subject.
Fasting Glucose Is a Risk Factor For Breast Cancer (http://cebp.aacrjournals.org/cgi/content/abstract/11/11/1361?maxtoshow=&HITS=150&hits=150&RESULTFORMAT=&fulltext=warburg&searchid=1114878374558_166&stored_search=&FIRSTINDEX=0&journalcode=cebp)
Carbohydrates and the Risk of Breast Cancer among Mexican Women (http://cebp.aacrjournals.org/cgi/content/full/13/8/1283)
The Insulin-like Growth Factor System in Cancer Prevention: Potential of Dietary Intervention Strategies (http://cebp.aacrjournals.org/cgi/content/abstract/14/1/195)

Zei
Thu, Apr-17-08, 17:04
Hmmm....what did those obese women eat that contributed to obesity? Low-fat carbs? Could that be related to getting cancer? And a host of other health problems? Also, did these obese women exercise regularly or do other healthy things? Could some genetic tendency to put on pounds also carry with it a tendency toward some diseases like cancer? What exactly are we really measuring here? I'm not really sure. I kind of wonder if flagging fat as a risk for cancer and suggesting we get skinny as the cure is anything like observing certain races of human beings get certain diseases more than other races. So would some expert really want to suggest they try to take on the appearance of another race as the cure like they do telling a fatter person to try to turn into a skinny one? The idea I'm trying to convey is I'm just not so sure things are so simple and that becoming a skinny person if possible is really a "cure" because maybe those naturally skinny people are inherently different somehow. Oh, well, hopefully this will make some sense.

KiaKaha
Thu, Apr-17-08, 23:58
I wonder how much of this has to do with the aspect that they raise about breast screening being ineffective in obese women.

I havent been for 5 years and keep telling myself to go but dont see the point. You go through an intensely humiliating screening which takes maybe 20 minutes or more - I had 18 xrays taken and was ultimately told it looks ok as far as we can see but we cant see much.

That was at 70lbs lighter than I am now. I can do without that kind of embarrassment and I figured if I have 18 xrays every year during breast screening that before too long I would develop a cancer risk from the screening itself.

I do wonder if this is a much larger factor than the study authors realise.

Why the difference between pre and post menopausal? Perhaps age related/ menopause related weight gain (very common) over a 10 year period (Assuming roughly the pre menopausal were up to age 40 and the post menopausal were 49 and over) may mean the 2 different groups were different levels of obese ie: the premenopausal group could easily have been 1 - 2 stones lighter on average.

The heavier you are (particularly abdominal obesity) the worse the breast screening experience. If you're 35 -40 and think you have to go for your 5 yearly screen, you might make the effort. If you're an even more obese 49+ year old, the thought of going every year for a marginally effective screen is a major turn off.

(Dont get me wrong - I fully support breast screening - just wish there was an effective and discreet option)