HOW COULD OBESITY LEAD TO CANCER?

Fat (also known as adipose tissue) has two main roles in the body. It exists to store calories in the form of chemicals called lipids, and a huge gland, sending out a constant stream of biological information and instructions that affect the rest of your body. This helps control processes like growth, metabolism and reproductive cycles. But because of their ability to turn biological processes on and off, the signals produced by fat have a darker side when it comes to cancer.

1. The oestrogen connection

One of the strongest links between obesity and cancer is an increased risk of breast and womb cancers in women who are overweight or obese after the menopause, and this relates to higher oestrogen levels. Large studies of women have shown a direct relationship between obesity, high oestrogen levels and breast and womb cancers and understanding this relationship has been critical in developing effective treatments – like tamoxifen and aromatase inhibitors – that work by cutting off oestrogen.

2. Metabolic chaos

The chemical processes going on constantly throughout the body – collectively known as metabolism – are complicated and tightly controlled, relying on a finely tuned web of information flowing between cells and organs. But the chemical signals produced by fat cells means that obesity can cause a major upset to this balance, and this is thought to be another way it makes cancer more likely.

One key hormone that acts as a master-controller of metabolism is insulin. It’s made by the pancreas and orchestrates how cells take up and process glucose from the blood.

Large studies of peoples’ blood chemistry have also shown links between high glucose (even at levels below those needed for a diagnosis of diabetes) and the risk of several types of cancer.

3. Inflammation

As people become obese, and more fat cells build up in their tissues, specialized immune cells (called macrophages) are called to the scene, possibly to clear up dead and dying fat cells. But as macrophages carry out their clean up job, they also release a potent cocktail of chemicals called cytokines that summon other cells to help them out. The number of macrophages in obese fatty tissue can be substantial – they can account for as many as four in 10 cells.

This ultimately creates a condition called chronic inflammation. The result of inflammation is a cocktail of signals that tell cells to divide, because after injury you need new cells for healing to occur. But the signals encouraging cell growth for healing can also support cancer cells dividing. In fact if we look at the genes that are turned on and off in inflamed tissue, it’s very similar to genetic changes we see in cancer cells.

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WHY ARE MORE MEN THAN WOMEN LIKELY TO DIE OF CANCER?

The American Cancer Society's comprehensive annual report on cancer incidence, mortality, and survival. It is published in CA: A Cancer Journal for Clinicians and is accompanied by a consumer version of the publication, Cancer Facts and Figures 2017. The report estimates that in 2017, there will be higher cancer incidence and mortality rate in men than women.

The report finds significant gender disparities in incidence rate of 20% higher in men than in women, while the cancer death rate is 40% higher in men.

The gender gap in cancer mortality largely reflects disparity in the distribution of cancers that occur in men and women, much of which is due to differences in the prevalence of cancer risk factors.

For example, liver cancer, a highly fatal cancer, is three times more common in men than in women, partly reflecting higher Hepatitis C/B virus infection, historical smoking prevalence, and excess alcohol consumption in men. The largest sex disparities are for cancers of the oesophagus, larynx, and bladder, for which incidence and death rates are about 4times higher in men. Melanoma incidence rates are about 60% higher in men than in women, while melanoma death rates are more than double in men compared to women.

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NEW STUDY LINKED ASTHMA SEVERITY TO BLACKS

Asthma a respiratory condition marked by attacks of spasm in the bronchi of the lungs, causing difficulty in breathing. It is usually connected to allergic reaction or other forms of hypersensitivity.

Airway inflammation is major part of asthma, and advancement in treatment are becoming more individualized based on the specific type of airway inflammation in a patient. Differences in airway inflammation can affect a patient's response to treatment, but whether the patterns of airway inflammation differ across race has, until now, been very unclear.

Black men and women are two to three times more likely than whites to be hospitalized or die from asthma. And while many factors contribute to the burden of asthma in African Americans -- such as access to health care and environmental exposures -- rates are disproportionate even when social and environmental elements are taken into account.

African Americans may be less responsive to asthma treatment and more likely to die from the condition, in part, because they have a unique type of airway inflammation, according to a recent study. 

The study is one of the largest and most diverse trials conducted in the U.S. on race and asthma, with 26 percent of the patients identified as African American. Researchers found that black patients were more likely to exhibit eosinophilic airway inflammation than whites, despite taking comparable doses of asthma medication, such as inhaled corticosteroids. The results are published in the Journal of Allergy and Clinical Immunology.

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