Obesity and cancer – the underestimated risk factor

61-year-old Mrs. S... sat in my OPD with two of her daughters—one of them an NRI.

She had observed vaginal spotting a few days back, and after it persisted for a week or more, she consulted a gynecologist, who promptly ordered a few tests and confirmed that she was suffering from endometrial cancer and referred her to me. She sat in my OPD "occupying more than the fair share of her chair" (body mass index of 38). I did not calculate the BMI of her daughters, but they would be having a similar figure. She lamented, "I did not do anything wrong in my life. Ours is a very traditional family. We do not even eat outside."

It took some efforts to explain to her that the "enemy" lies in the high-calorie food that led to her being obese in the first place. Luckily, scans showed that her cancer was in a very early stage. I operated on her, and she recovered smoothly; she did not require any adjuvant treatment. The trio was back in the OPD a few months later to thank me with a box of home-made "ghee ravva laddoos," saying it was her favorite dish! Some people DO NOT CHANGE!

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Quote from a recently published article in Lancet on the various causes of cancer: "Risk-attributable cancer death and DALY burden increased globally from 2010 to 2019, with metabolic risk factors contributing to the largest percentage increases, most notably in low and low-middle Socio-demographic Index countries.”

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What this complicated statement actually means is that obesity is becoming very common in developing and underdeveloped countries. It is now one of the main reasons for increase in cancer rates in these countries.

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Traditionally, the focus has been on tobacco and chronic alcoholism as the commonest causes of cancer. However, nowadays everyone knows that these cause cancer, and quite a few people have been motivated to quit. Some people do continue using these substances even after knowing the perils, and nothing much can be done to dissuade them. What is less known is that obesity causes quite a few cancers like those shown in the picture.

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"Being overweight or obese" is not looked upon as condescendingly as smoking or heavy drinking... This perception needs to change. Just like in the case of tobacco or alcohol usage, it's not just cancer that these people need to be worried about. They have a higher risk of heart attack, stroke, diabetes, arthritis, etc

Endometrial (uterine) cancer and colorectal (large intestine) cancer are some of the common obesity-related cancers that I see in my present-day practice, and I foresee that I will be seeing more and more of these in the future as India keeps "developing.". Fervountly hope that Indians prove me wrong!

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Pic courtesy: CDC, USA

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