Excess body fat promotes the development of cancer because it leads to two important changes in the body’s chemistry: (1) the development of the so-called insulin resistance syndrome or metabolic syndrome; and (2) the increased production of estrogen. Insulin resistance and cancer. Fat cells normally release fatty acids into the bloodstream. These molecules can be used for energy and actually compete with glucose as a source of energy by the body. In addition, fatty acids cause chemical changes inside our cells. One important change is making insulin work harder to do its job, that of having glucose transported from the outside to the inside of cells. This situation is termed insulin resistance, and it often leads to adult-onset diabetes. Insulin resistance forces the body to pump out more insulin in order for cells to receive the glucose they need.
As a result, higher levels of insulin are found in the bloodstream, and this in turn causes an increase in related chemicals called insulin-like growth factors (IGFs). High levels of insulin and IGFs create an unhealthy atmosphere for the cells they bathe, promoting heart disease, cancer, obesity, and a shortened life span. Insulin-like growth factors promote cancer because they enhance the survival and growth of cells and prevent their death. This would be especially unwanted if a cell were to sustain a genetic mutation. Normally, such a cell would be sensed as damaged and targeted for elimination by the body. But in the presence of insulin resistance and high IGF levels, the cell may survive; the damaged cell can then go on to sustain additional DNA mutations that ultimately lead to cancer. In this way excess body weight, through the creation of insulin resistance, promotes the development of cancer.
More fat, more estrogen, more breast cancer. The ovaries are the main source of estrogen production in menstruating women. When ovarian function ceases upon menopause, estrogen is still produced in the female body, although in lesser amounts. In postmenopausal women, fat becomes the main estrogen factory, with higher body weights correlating with higher estrogen levels.
As every woman knows from the experience of menstruation, estrogen stimulates the growth of the breast and uterus. Just as the normal cells in these tissues multiply in response to estrogen, so do (most) can cers derived from them. Therefore, the higher the blood levels of estrogen and related sex hormones, the greater the risk of developing breast and uterine cancer.
Recent studies into how weight affects breast cancer control have shown that women who are overweight at the time of a breast cancer diagnosis and those who gain and retain extra weight after the diagnosis have an increased risk of breast cancer recurrence. The more weight gained, the greater the chances that the cancer may return. It is therefore recommended that women strive hard to maintain weight during breast cancer treatment or lose any weight gained after treatments end. The connection between fat and breast cancer is in part caused by the fact that fat contains an enzyme called aromatase that increases estrogen production. So even after menopause, when the ovaries have ceased producing estrogen, the hormone still gets made in the body. A class of medicines called aromatase inhibitors (AIs) blocks aromatase from working and thereby drastically reduces the levels of estrogen in the bloodstream. AIs such as femara (Letrozole), anastrazole (Arimidex), and aromasin (Exemestane) are very effective in fighting breast cancer in postmenopausal women.
Regular exercise is a critical part of a healthy pattern for living. Exercise and being physically fit yield tremendous physical, emotional, and mental dividends. Exercise is recommended for cancer patients at all stages of treatment, especially those who have completed cancer therapy. It can maintain strength, improve fatigue, relieve stress, and prevent weight gain, among other benefits. Studies of breast and colon cancer survivors indicate that regular exercise can help prevent a cancer recurrence. The American Cancer Society recommends aerobic exercise (for example, walking, swimming, cycling, taking an exercise class) for at least thirty minutes five days per week.
Cancer treatments may limit a person’s ability to exercise. If you are a cancer patient undergoing treatment, you should do less than you think you are capable of and discuss the best time to exercise in relation to your treatments with your oncologist. There will be times when you must rest because of the effects of the cancer or the treatments, when exercise is too difficult to engage in. During these times, short walks, stretching, or gentle yoga may be extremely helpful and not too taxing. Many patients also find that Reiki (a Japanese technique to promote relaxation and healing) and massage can relieve stress and improve movement. Many cancer centers offer these programs, often free of charge or for a nominal fee.
In contrast to the difficulties in linking specific foods to the development or prevention of cancer, no such problems exist regarding tobacco. Tobacco products have been proven beyond doubt to induce the changes in normal cells required to convert them into cancerous ones. This has been shown in the laboratory on cells treated with chemicals present in tobacco, in lab animals raised on air filled with tobacco smoke, and in studies of humans who smoke or use any tobacco product-cigarettes, cigars, pipes, chewing tobacco, or snuff. These products are poison because they are full of carcinogens; not even tobacco companies dispute this reality.
It is well established that 90 percent of lung cancers are caused by smoking and that lung cancer is the leading cause of cancer-related death in the United States and worldwide. Yet tobacco also plays a role in bringing about many other cancers: bladder, cervix, esophagus, kidney, larynx, oral/nasal cavity, pancreatic, stomach, and leukemia. It has been estimated that if tobacco were banned, one-third of all cancers in industrialized nations would be eliminated. Talk about a miracle cure! Why is tobacco such a potent cancer-causing substance? Because it is the perfect carcinogen: it contains chemicals (such as nicotine and NNK, a nitrosamine) that: (1) directly cause mutations in DNA; (2) prevent the damaged cells from dying; and (3) create addiction, causing the user to perpetuate the damage to the body. If these events happen repeatedly, year after year, then the risks that a cancer will form are very high.
But all is not lost, because smokers can benefit from quitting at any time during their lives. For those who smoke but have never had cancer, quitting even at age sixty can add years to their life. For those smokers who have survived cancer, then quitting smoking is one of the best things they can do to prevent another cancer. Moreover, even if smokers are currently battling cancer, then quitting is still very important. Not only will quitting improve their health and their body’s ability to tolerate the recommended treatments but they will be improving their chances of survival.
Although few studies have been done in other smoking-related cancers, I suspect that they would yield the same results. Please speak to your doctor in order to get the help you need to quit smoking. If you are a smoker, totally commit yourself to quitting. It is of the utmost importance. Advice on quitting smoking can be found in many places, including doctor’s offices, the Internet, and in publications.
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