Gastric Sleeve and Cancer: What You Need to Know!

The relationship between obesity and cancer has garnered significant attention in medical research due to the profound implications for public health. Obesity, characterized by an excessive accumulation of body fat, is a complex condition influenced by genetic, behavioral, and environmental factors. It has been robustly linked to an increased risk of several types of cancer, including breast, colorectal, endometrial, pancreatic, and liver cancers, among others.

One promising approach is weight-loss surgery, which includes various procedures designed to induce significant weight loss in individuals with severe obesity. Among these, gastric sleeve surgery has gained popularity due to its effectiveness and relatively straightforward surgical approach. This procedure not only facilitates substantial and sustained weight loss but also brings about numerous metabolic and hormonal changes that could potentially reduce cancer risk.

This blog will explain the link between between obesity and cancer and how gastric sleeve surgery helps reduce cancer risk.

The Link Between Obesity and Cancer

To understand the potential benefits of gastric sleeve on cancer risk, it is essential to first recognize the established relationship between obesity and cancer. 

According to the Centers for Disease Control and Prevention (CDC), about 42% of American adults are affected by obesity. This condition raises the risk of developing 13 types of cancer, which together make up 40% of all cancer diagnoses in the United States each year.

Mechanisms Linking Obesity to Cancer

Hormonal Changes:

Insulin and Insulin-like Growth Factors (IGFs): Obesity often leads to insulin resistance, resulting in higher levels of insulin and IGFs. These hormones can promote the growth of cancer cells by stimulating cell proliferation and inhibiting apoptosis (programmed cell death).

Sex Hormones: Excess body fat increases the production of estrogen in adipose tissue. Elevated levels of estrogen may result in breast, endometrial, and ovarian cancers.

Inflammation:

Chronic Inflammation: Obesity is associated with a state of chronic low-grade inflammation. Adipose tissue in obese individuals releases inflammatory cytokines, which can promote tumor development by causing DNA damage, increasing cellular proliferation, and inhibiting apoptosis.

Metabolic Dysregulation:

Adipokines: Fat cells (adipocytes) produce various bioactive molecules called adipokines, such as leptin and adiponectin. In obesity, altered levels of these adipokines contribute to an environment that supports cancer growth. For example, leptin promotes cell proliferation, while decreased levels of adiponectin associate with increased cancer risk.

READ: Obesity and Cancer

Types of Cancer Associated with Obesity

1. Breast Cancer: Postmenopausal women with obesity have an increased risk due to higher estrogen levels produced by adipose tissue.
2. Endometrial Cancer: Increased estrogen levels also contribute to the risk of endometrial cancer.
3. Colorectal Cancer: Obesity is linked to colorectal cancer through mechanisms such as insulin resistance and chronic inflammation.
4. Esophageal Adenocarcinoma: Increased abdominal fat can lead to gastroesophageal reflux disease (GERD), a risk factor for esophageal cancer.
5. Pancreatic Cancer: Insulin resistance and chronic inflammation are significant factors.
6. Kidney Cancer: Excess body fat can affect kidney function and hormone levels, increasing cancer risk.
7. Liver Cancer: Obesity-related non-alcoholic fatty liver disease (NAFLD) can progress to liver cancer.
8. Gallbladder Cancer: Obesity increases the risk of gallstones and chronic inflammation in the gallbladder, leading to cancer.

Weight Loss Surgery and Cancer Risk Reduction 

A study by the Cleveland Clinic, published in JAMA, reveals that adults with obesity who underwent bariatric surgery had a 32% lower risk of developing cancer and a 48% lower risk of cancer-related death compared to those who did not have the surgery.

Significant and sustained weight loss achieved through gastric sleeve has been shown to reduce the risk of developing obesity-related cancers. This can be attributed to several factors:

Reduced Inflammation:

Obesity is associated with chronic low-grade inflammation, which can promote the development and progression of various cancers. Weight loss after gastric sleeve surgery helps reduce systemic inflammation, potentially lowering cancer risk.

Improved Metabolic Health:

Obesity is intricately connected to metabolic disorders, including insulin resistance and imbalanced hormone levels, which may enhance the risk of cancer development. By improving insulin sensitivity and restoring hormonal balance, gastric sleeve surgery may help mitigate these cancer-promoting factors.

Favorable Changes in Adipokines and Cytokines:

Adipose tissue (fat) secretes various bioactive molecules, called adipokines and cytokines, which can influence cancer risk. Weight loss after VSG surgery can lead to beneficial changes in the levels of these molecules, potentially reducing cancer risk.

Reduced Estrogen Levels:

Excessive body weight is linked with the elevated concentrations of the hormone estrogen in the body. This heightened estrogen level can potentially stimulate the growth and proliferation of certain types of cancers that are sensitive to hormonal influences, including breast cancer and endometrial cancer (cancer of the uterine lining). Weight loss achieved through gastric sleeve surgery can lower estrogen levels, potentially reducing the risk of these cancers.

National Cancer Institute has reported that gastric sleeve surgery reduces risk of developing certain types of cancer, including:

1. Breast cancer: As per the study conducted at the University of Gothenburg, bariatric surgery including gastric sleeve has resulted in a significant reduction in the risk of developing breast cancer, likely due to the combined effects of weight loss, improved metabolic health, and reduced estrogen levels.
2. Endometrial cancer: Obesity is a major risk factor for endometrial cancer. Studies show that bariatric surgery including Gastric sleeve may reduce the risk of developing this type of cancer, primarily due to the favorable effects of weight loss on hormonal and metabolic factors. 
3. Colorectal cancer: Research published by PubMed has suggested that gastric sleeve surgery may lower the risk of developing colorectal cancer, possibly through mechanisms such as improved insulin sensitivity, reduced inflammation, and changes in gut hormone levels.

It’s important to note that while gastric sleeve surgery may provide a protective effect against certain types of cancer, it does not eliminate the risk entirely. Regular follow-up care, adherence to a healthy lifestyle, and recommended cancer screening guidelines are still essential for maintaining long-term health and minimizing cancer risk.

Does Gastric Sleeve Prevent Cancer?

There is no direct evidence that gastric sleeve surgery can prevent cancer specifically. However, gastric sleeve can lead to significant weight loss in obese individuals, and sustained weight loss will eventually reduce the risk of developing certain types of cancer.

Conclusion

Overall, the evidence suggests that gastric sleeve surgery can significantly reduce the risk of obesity-related cancers through substantial weight loss and favorable hormonal and metabolic changes. While there are specific areas that require ongoing research and monitoring, the benefits of VSG surgery in terms of cancer risk reduction are compelling.

Patients considering gastric sleeve surgery should engage in thorough discussions with their healthcare providers to fully understand the risks and benefits. Staying informed about new research findings will be essential for making the best health decisions.