It has been documented in countless studies that being obese makes one at risk for several conditions and diseases. One of these diseases is the dreaded cancer. As the American Cancer Society (ACS) explains, “excess body weight is thought to be responsible for about 8% of all cancers in the United States, as well as about 7% of all cancer deaths.”
The same source goes on to say that obesity has been proven to increase a person’s risk of the following kinds of cancer: breast, colon and rectum, endometrium, esophagus, kidney, and pancreas. On the other hand, being obese or overweight may also put a person at risk of contacting the following kinds of cancer: aggressive forms of prostate cancer, cervical cancer, ovarian cancer, gallbladder cancer, liver cancer, multiple myeloma, and non-Hodgkin lymphoma. Finally, having a larger waistline is attributed to an increased risk of colorectal, breast, endometrium, and pancreatic cancer.
Further research is currently being done to solidify the link between cancer risk and obesity. While this is the focal point of many researches, there is another pressing topic to explore. Specifically, the connection between fat cells (and in essence, obesity), to the efficacy of cancer treatment.
Definition of Terms
A fat cell, or a cell containing fat, is known in the medical community as an adipocyte. According to MedicineNet.com, an adipocyte is “a connective tissue cell that has differentiated and become specialized in the synthesis (manufacture) and storage of fat.”
This fatty cell is essential to the body for a number of reasons. The same source labels these functions as, “maintaining proper energy balance, storing calories in the form of lipids, mobilizing energy sources in response to hormonal stimulation, and commanding changes through signal secretions.”
Meanwhile, connective tissue is defined as “a material made up of fibers forming a framework and support structure for body tissues and organs. Connective tissue surrounds many organs.” There are many connective tissues in the body, many of which are situated near prominent cancerous sites.
The Cancer Link
A new study reveals that adipocytes can absorb common chemotherapy drugs and convert them into less toxic forms. This means that the efficacy of chemotherapy drugs are significantly reduced, to the point that they may be rendered ineffective.
The study, which was supported in part by the National Cancer Institute (NCI), explains that “by absorbing and breaking down the drugs, the fact cells may be removing the drugs from the immediate environment around tumor cells in bone marrow or other areas of the body where fat cells are plentiful. This finding may help explain why obesity is linked to poorer outcomes in several types of cancer.”
This premise was first observed when experts noticed obese and non-obese children reacted differently to the treatments acute lymphoblastic leukemia (ALL). Those who were obese before getting diagnosed have a 50% higher relapse rate in comparison with children of normal weight. Aside from this, obese adults have poorer outcomes when it comes to prostate, colon, ovarian, and breast cancer, in comparison with adults of normal weight. Since many cancers occur in areas where there are a lot of fatty cells, examining the effects of medicine on these cells has a lot of merits.
The researchers tested this premise with daunorubicin, an anti-cancer chemotherapy drug usually used to treat acute myelogenous leukemia (AML), ALL, and acute promyelocytic leukemia (APL). They grew ALL cell lines with different types of connective tissue cells, one with fat cells, the either with fibroblasts. The cells were then treated with daunorubicin. During the experiment, they saw that the accumulation of the medicine was reduced in cells with fat cells, but not fibroblasts.
Upon closer inspection, they also learned that aside from absorbing the medication, the fat cells also broke them down to a less toxic, and therefore less potent, form. Another experiment showed that ALL cells grown with fat cells survived and multiplied, while ALL cells grown with fibroblasts and other cell types did not grow as much.
To further solidify their findings, the team then explored samples of intact fat tissues from cancer patients, which showed how the cells could absorb and inactivate daunorubicin. Aside from this, they also tested if the cells behaved similarly to the chemotherapy drugs doxorubicin and mitoxantrone. While doxorubicin was broken down to a less active form, it was not with the same intensity that was displayed with daunorubicin. Mitoxantrone, however, remained unchanged.
The NIH concludes, “Finally, the team found evidence that human fat cells produce high levels of several enzymes capable of breaking down anthracyclines like daunorubicin and doxorubicin… they detected some of these enzymes in fat cells from bone marrow of children being treated for ALL.”
What Does this Mean?
There is an enzyme in fatty tissues that absorbs chemotherapy drugs and makes them ineffective, which might explain why the recurrence rate of the cancer is higher in children who are obese. A problem this poses is that if the fatty tissues can absorb the medication, then this could contribute to the probability of drug-resistant tumor cells growing in the future.
The study at this point is still inconclusive, regarding how they can provide better treatment. However, the researchers are continuing with their program to determine methods to make drugs more effective against cancer cells. One of the measures they are looking into is to “measure the concentration of drug in the tumor microenvironment in a living person or mouse so that they can assess the effects of nearby fat cells.”
Another thing researchers are looking into is how to best deliver medication to obese patients in a way that their body will accept the best. This may mean “giving the drugs more often or at higher doses, designing drugs that are resistant to the enzymes in fat cells, or developing treatments that will block those enzymes.”
In the end, the medical community is still hard at work to figure out how to best combat cancer cells. However, this is a breakthrough that could partially explain why being obese significantly affects a person’s ability to combat cancer.
Alternative Treatments to Conventional Methods
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