OVARIAN CANCER and US: obesity

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Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts

Sunday, May 27, 2012

Time to Ovarian Cancer Return Not Tied to BMI - in Meeting Coverage, ASCO from MedPage Today



Medical News: Time to Ovarian Cancer Return Not Tied to BMI - in Meeting Coverage, ASCO from MedPage Today


Action Points


  • Note that this study was published as an abstract and will be presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
  • A study found that obesity did not affect recurrence, time to recurrence, or progression-free survival in women with epithelial ovarian cancer following surgery and adjuvant chemotherapy without evidence of disease during treatment.
  • Note that the approximately one-third of patients who had BMI >30 kg/m2 had similar recurrence rates and time to recurrence as the two-thirds of non-obese patients.

Friday, May 18, 2012

paywalled: Lipid Profiles and Risk of Breast and Ovarian Cancer in the Swedish AMORIS Study



WIKI: Lipid metabolism refers to the processes that involve the intercourse and degradation of lipids.
The types of lipids involved include:
                                                ~~~~~~~~~~~~~~~~~
Lipid Profiles and Risk of Breast and Ovarian Cancer in the Swedish AMORIS Study



Background: 
Obesity is a risk factor for breast (BCa) and ovarian cancer (OCa); the mechanisms of action are not completely understood. Perturbed lipid metabolism often accompanies obesity; we therefore ascertained the associations between lipid components and BCa and OCa risk in a prospective cohort study. 

Methods: 
234,494 women with baseline measurements of triglycerides (TG) and total cholesterol(TC) and glucose were selected from the AMORIS database. 27,394 had measurements of HDL,LDL, apolipoprotein (Apo) B and A-I. Associations between quartiles and dichotomized values of lipid components and BCa and OCa risk were analysed using Cox proportional hazard models.

Results: 
We identified 6,105 women diagnosed with BCa and 808 women diagnosed with OCa. A weak trend was observed between TG and BCa (HR: 1.01 (CI95% 0.94-1.09), 0.93 (0.86-1.00) 0.91 (0.84-0.99) 2nd 3rd and 4th quartiles; P = 0.01). No other associations between lipid components and risk of BCa or OCa showed statistical significance. 

Conclusions: 
A weak protective association was found between levels of TG and risk of BCa. 

Impact: An analysis including information on tumour characteristics of OCa and BCa may provide more insight in possible links between lipid metabolism and the risk of these cancers.

Wednesday, May 09, 2012

paywalled: Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis



Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis.

Abstract

Obesity is associated with poor survival after breast cancer diagnosis in individual studies and meta-analyses. Evidence regarding associations of obesity with breast cancer-specific survival (BCSS) and overall survival (OS) in relation to hormone receptor status, or BCSS in relation to menopausal status has not been evaluated in a previous meta-analysis. ............ These findings led us to conclude that there is no evidence showing that the association of obesity with breast cancer outcome differs by hormone receptor or menopausal status. This has implications for studies of weight loss interventions in the adjuvant BC setting.

Sunday, April 15, 2012

Obesity and cancer outcome : The Lancet



Obesity and cancer outcome : The Lancet

Obesity and cancer outcome

 
12 million Americans are cancer survivors and a staggering two-thirds of Americans are currently considered overweight or obese. On April 3, the National Cancer Policy Forum of the US Institute of Medicine released a welcome report entitled The Role of Obesity in Cancer Survival and Recurrence. Many epidemiological studies have identified obesity as a factor in cancer risk and prognosis. Obesity is associated with higher cancer incidence, recurrence, progression, and death. The report emphasises how little is still known about the precise cellular mechanisms that link obesity with cancer.
Adipose tissue can behave as an endocrine organ by generating hormones, growth factors, and cytokines that can disrupt regulation of cell growth and survival—the hallmark of malignancy. Knowing the precise cellular targets involved in this interplay could lead to targeted therapeutic approaches for controlling both cancer and obesity. For example, appropriate animal models could allow investigation of mechanisms of obesity and diabetes in precise genetic models of human cancers.
What is not yet known is whether weight management changes the prognosis and outcome in different cancers. The simple solution of tracking individuals' BMI and bodyweight during clinical trials to analyse effect on cancer outcomes needs to become standard practice. Another area of clinical controversy is related to proper chemotherapy dosing in obese cancer patients. Total body-surface area is used to calculate the chemotherapy dose, which does not take into account the body's composition (such as an individual's fat percentage). This approach often leads to suboptimum doses of chemotherapy.
But the most important lesson of this report comes from the basic science of obesity-associated cancer risk. Our population-level responses—which have largely failed—are based on a far too simplistic understanding of how obesity contributes to cancer. To address this challenge demands not more poorly thought out intervention trials. 
 Instead, we need greater understanding of the biological mechanisms underpinning cancer and obesity.

Tuesday, April 03, 2012

abstract: Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden.



Blogger's Note: see also posting regarding BRCA1/heart disease/doxorubicin research... (blog posting Apr 3 eg. as per below abnormal lipid levels/ovarian cancer)

                ~~~~~~~~~~~~~~~~

Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden.

Abstract

OBJECTIVE:

To study how the incidence of cancer is related to diabetes, obesity or abnormal blood lipids.

METHODS:

Diagnosis of diabetes, obesity or abnormal blood lipids was studied 0-10 years prior to the diagnosis of cancer in 19,756 cases of cancer and in 147,324 controls matched regarding age, sex and domicile.

RESULTS:

Diabetes was significantly more common prior to diagnosis in patients with liver, pancreatic, colon and urinary tract/bladder cancer and in patients with breast cancer diagnosed with diabetes 0-4 years prior to the cancer diagnosis. A lower risk of diabetes was seen in patients with prostate carcinoma among individuals with diabetes diagnosed 5-10 years prior to the cancer diagnosis. The findings remained after adjusting for obesity and high blood lipids. Obesity was significantly more common in patients with endometrial, colon and kidney cancer and with breast cancer above the age of 60 years in those where obesity was diagnosed close to the diagnosis of cancer. High blood lipids were significantly more common in patients with ovarian cancer and less common in patients with breast cancer.

CONCLUSIONS:

The study confirms some previous findings concerning comorbidity and cancer and highlights some new ones.

Appropriate Chemotherapy Dosing for Obese Adult Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline [ASCO Special Articles]



Appropriate Chemotherapy Dosing for Obese Adult Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline [ASCO Special Articles]:

pdf (open access)

Purpose
To provide recommendations for appropriate cytotoxic chemotherapy dosing for obese adult patients with cancer.

Methods
The American Society of Clinical Oncology convened a Panel of experts in medical and gynecologic oncology, clinical pharmacology, pharmacokinetics and pharmacogenetics, and biostatistics and a patient representative. MEDLINE searches identified studies published in English between 1996 and 2010, and a systematic review of the literature was conducted. A majority of studies involved breast, ovarian, colon, and lung cancers. This guideline does not address dosing for novel targeted agents.

Results
Practice pattern studies demonstrate that up to 40% of obese patients receive limited chemotherapy doses that are not based on actual body weight. Concerns about toxicity or overdosing in obese patients with cancer, based on the use of actual body weight, are unfounded.

Recommendations
The Panel recommends that full weight–based cytotoxic chemotherapy doses be used to treat obese patients with cancer, particularly when the goal of treatment is cure. There is no evidence that short- or long-term toxicity is increased among obese patients receiving full weight–based doses. Most data indicate that myelosuppression is the same or less pronounced among the obese than the non-obese who are administered full weight–based doses. Clinicians should respond to all treatment-related toxicities in obese patients in the same ways they do for non-obese patients. The use of fixed-dose chemotherapy is rarely justified, but the Panel does recommend fixed dosing for a few select agents. The Panel recommends further research into the role of pharmacokinetics and pharmacogenetics to guide appropriate dosing of obese patients with cancer.

Friday, March 30, 2012

Cancerwise: Obesity and Cancer Risk: Our Expert Weighs In



Obesity and Cancer Risk: Our Expert Weighs In: By Jennifer Montgomery, MD Anderson Staff Writer

A new report shows that cancer death rates are still on the decline in the United States, but increasing obesity remains a concern.

The Annual Report to the Nation on the Status of Cancer, released March 28, notes that for more than three decades, too much weight, too little exercise and unhealthy eating habits have been second only to tobacco as preventable causes of disease and death.

Since the 1960s, the report says, tobacco use has declined by one-third, but obesity rates have doubled. According to the report, 2 in 3 adults and 1 in 3 kids are overweight or obese, which places them at risk for not only heart disease and diabetes, but also cancer. After reviewing more than 7,000 studies, the report's researchers have identified six cancers associated with being overweight or obese:
  • Esophageal adenocarcinoma
  • Colon and rectal cancer
  • Kidney cancer
  • Pancreatic cancer
  • Endometrial cancer
  • Breast cancer among postmenopausal women
This review also finds convincing evidence of an association between lack of sufficient physical activity and increased risk of colon cancer. A probable association is cited for post-menopausal breast and endometrial cancers.The report notes that less than half of adults get enough physical activity. Youths get even less. Lorenzo Cohen, Ph.D., professor in the Department of General Oncology and director of MD Anderson's Integrative Medicine Program, shares his reaction to the annual cancer report, as well as suggestions for how people can take action now to reduce obesity and prevent cancer.



The Annual Report to the Nation on the Status of Cancer looks at U.S. cancer numbers from 1975 and 2008. It's a collaboration of researchers from the Centers for Disease Control and Prevention, the North American Association of Central Cancer Registries, the National Cancer Institute and the American Cancer Society.

Additional highlights from the report:

  • Death rates from all cancers combined for men, women and children continued to decline in the United States between 2004 and 2008.
  • New cancer diagnoses among men fell an average of 0.6% per year over the same period. 
  • New cancer diagnoses among women declined 0.5% per year from 1998 through 2006, but rates leveled off from 2006 through 2008.
  • For the second consecutive year, mortality rates for lung cancer have decreased among women. Lung cancer death rates in men have been decreasing since the early 1990s.
  • Breast cancer incidence rates among women declined from 1999 through 2004 and plateaued from 2004 through 2008.
  • Colorectal cancer incidence rates decreased among men and women from 1999 through 2008.
  • Incidence rates of some cancers, including pancreas, kidney, thyroid, liver and melanoma, increased from 1999 through 2008.
  • Among racial and ethnic groups, the highest cancer incidence rates between 2004 and 2008 were among black men and white women. Cancer death rates from 2004 through 2008 were highest among black men and black women, but these groups showed the largest declines between 1999 and 2008, compared with other racial groups.
  • Among children age 19 or younger, cancer incidence rates increased 0.6% per year from 2004 through 2008, while death rates decreased 1.3% per year during the same period.

Saturday, July 24, 2010

Obesity is associated with improved survival in patients with organ-confined clear-cell kidney cancer (see 'Note')



Note: while not ovarian cancer specific (noting the common cell type of clear cell) the conclusion is interesting

CONCLUSION: We identified overweight as an independent prognostic marker of improved cancer specific survival in patients with organ-confined but not advanced RCC. Basic research is required to resolve the dilemma of why, if a higher BMI predisposes to RCC, it concurrently prolongs survival after patients have undergone (partial) nephrectomy.