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The Obesity-Cancer Connection, and What Can be Done About It

By Dr. David C. Pate, News and Community
April 15, 2013

Dr. Dan Zuckerman, whose writing appears below, is an outstanding oncologist and one of our outstanding physician leaders at St. Luke's. 

I was talking to him about my concerns about the epidemic of childhood obesity and my fear that we would be seeing unprecedented levels of hypertension, hyperlipidemia, arthritis, heart disease, stroke, and even cancer.  He provided me with very specific information about the cancer-obesity association and made me even more concerned than I was.

Please enjoy his extremely informative report, and share it with everyone you can think of; we have to get the word out.

Growing up as the son of oncologist, I dreamed of becoming a scientist, finding a cure for cancer, and putting my dad out of business. Thirty years later, I’m working alongside him at St. Luke’s MSTI. 

I’m proud and fortunate to do so, and to know that we’re providing world-class cancer care here in Idaho. But the rates of cancer now are actually higher than when I was a kid, not lower.

Dr. Pate has asked me to think about what St. Luke’s MSTI could do to help bring down the rates of cancer in our region. We do a great job at diagnosing and treating cancers, but what role do we – should we – take in preventing cancers? That led to the question: What is causing the rising incidence of cancer? 

One important cause is obesity.

It is widely known that smoking leads to cancer and that obesity leads to cardiovascular disease. But many may not be aware of the strong link between obesity and cancer. We need to turn more of our attention to cancer prevention and health maintenance, and not just treating cancer when it happens.

The rising rate of new cancer cases mirrors the rising rate of obesity in our country. Obesity contributes to at least eight cancers: breast, endometrial, colorectal, esophageal, kidney, gallbladder, thyroid, and pancreas. The National Cancer Institute (NCI) estimates that 85,000 new cases of cancer per year in the United States are due to obesity, and it is projected that by 2030, more than 500,000 additional cancer diagnoses will be linked to obesity. These cancers don’t have to happen.    

The science is still emerging, but here is what we know:

  • Fat cells, also called adipocytes, produce excess estrogen. Abnormal breast and endometrial cells feed off of estrogen, just like fuel on a fire.
  • Fat cells increase levels of insulin and a related protein called insulin-like growth factor 1 (IGF-1), which promote the growth of certain cancers. 
  • Fat cells disrupt the balance of hormones called adipokines, which interferes with the body’s own natural defenses against cancer.
  • Obesity and lack of activity decrease autophagy, a critical garbage collecting and recycling process inside our cells. Inhibiting this leads to the accumulation of carcinogenic molecules from within.
  • Obesity often induces a state of low-level, chronic inflammation in the body. This inflammation pushes us closer to the edge of developing a cancer.
A recent Gallup study on obesity ranked Idaho 41st in the country, meaning 40 states are fatter than we are. That offers some solace, and perhaps speaks to the fact that we are more hard-working, active, and outdoorsy than other parts of the country. 

However, 24.4 percent of Idahoans are obese. In 1985, fewer than 10 percent of Idahoans were obese, so we’re moving in the wrong direction. 

The solutions are simple, but hard. We need to eat better. We need to be more active.  The luxuries and conveniences of modern life in America have conspired to make our default mode bad eating and more sitting. We take two quasi-beef patties and special sauce and serve it up in a tidy Styrofoam box in 30 seconds flat. We accept that “food” comes wrapped in plastic and cardboard. We sit in our car. We sit at the office. We sit on our couch.  

Like anyone, I catch myself skipping my morning run or rustling through a crinkly bag of chips while sitting at my desk. I wonder, is chip dust the other Agent Orange? Fortunately, my job and my family motivate me to limit these lapses. 

We want to make it easier for people to make the right health choices, choices that will lead to less cancer. At St. Luke’s, we have our Healthy U program, which promotes a healthy lifestyle for all employees through education and financial incentives. Less obesity = less cancer = healthier workers + lower health care costs.   

Our cafeteria menu has been revamped to include more fruits, vegetables, and well-balanced, lower-calorie options. As an oncologist, does part of me want to toss out the deep-fat frier and turn off the soda machine? Sure. But I know that’s not a realistic solution.

I see St. Luke’s MSTI getting even more involved in the community to share the message that activity = cancer prevention. We already have a great relationship with the Y through the LiveStrong program, but that focuses on patients after they’ve been diagnosed with cancer. As a leader with St. Luke’s MSTI, I want to commit resources, education, and programming through the YMCA and other organizations to get more people active so they never get cancer in the first place. 

Boise Mayor David Bieter had it right when he launched the “Walk 150” program in conjunction with Boise’s sesquicentennial. It’s a commitment to himself and a motivation to fellow Boiseans to walk 150 miles this year, all while enjoying the beauty of Boise. Urban planners and sociologists talk about “walkable” cities as “livable” cities. They don’t know how right they are. More walkability = less cancer = more livability. 

St. Luke’s MSTI would want to team with the city of Boise and our surrounding communities to support planning that makes it easier, safer, and more enjoyable to walk and ride bikes. Am I talking about things beyond the scope of a traditional cancer center? Maybe, but that’s a good thing. 

St. Luke’s MSTI has provided excellent cancer treatment for the last half-century. We will continue to do that. Now we need to strengthen our role in the community in terms of health promotion and cancer prevention. Combating the rise of obesity is a first step.  And quite literally, with every step we take, we’ll make it so fewer of us ever have to face cancer.

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.

Related Specialty

Medical Oncology

Treatment for cancer and blood disorders using medicine, including chemotherapy and other therapies.