The link between endometrial cancer and obesity

by Theresa Pallotta, MBS 2020, Geisinger Commonwealth School of Medicine
Mentor: Darina Lazarova, PhD

There are often people in our lives around whom the universe seems to rotate. It seems that the sun rises and sets on their heads, and in their absence the world would stop spinning. For me, that person was my grandmother or my “Nona” as my sisters and I affectionately called her. She was the center of our lives and the fabric that neatly tied my entire family together. When we lost her to uterine cancer in 2001, it took years for our lives to be pieced back together and even then my grandfather could tell you at any moment how many years, months, weeks, days, and hours it had been since she had left us. As an eight-year old, I was naturally inquisitive but after her death, I was desperate to find answers to the question of how a seemingly healthy and very active woman’s life could be cut short by such debilitating disease. According to the National Cancer Institute (NCI), endometrial cancer accounts for 6% of all cancers in women and for 3.5% of all new cancer cases in the United States. Women who have already gone through menopause and are over the age of fifty are the ones most commonly diagnosed with endometrial cancer and the NCI has predicted 65,620 new cases to be diagnosed in the year 2020. These are our mothers, aunts, sisters, grandmothers and friends. If the cancer is diagnosed at an early stage, surgery can be done as a first line treatment. However, if the cancer is not caught at an optimal time, as unfortunately was the case with my grandmother, then other treatment options have to be pursued such as chemotherapy and radiation. Diet plays a key role in the development of this cancer type. High-fat diets, which include fried or processed foods, or those that consist of surplus amounts of sucrose (sugar), such as cakes, milkshakes, and fruit juice drinks, have been shown to be key players in the progression of endometrial cancer. These unhealthy diets encourage the body to enter a state of chronic inflammation that alters normal cell signaling pathways and impairs the body’s natural equilibrium known as “homeostasis”. Also, unhealthy diet changes the composition of the intestinal microorganisms and thus, makes the gut more permeable. This increases the rate at which one gains weight. Additionally, hormones made by fat cells help cancer cells to spread from organ to organ. One study confirmed that obese women had a three-fold chance of developing endometrial cancer compared to women who were of average weight. At a glance, obesity and weight gain promote the development of endometrial cancer. An excess of fat cells can lead to changes in signaling pathways in the body and may also release hormones that can either promote mutations that lead to cancer or help cancer to spread throughout the body. In my opinion, awareness that obesity can lead to many different chronic disease states, including cancer, is key in promoting healthy lifestyles. Lifestyle interventions that encourage exercise and healthy eating habits are paramount. In particular, educating the public about the dangers of certain food types should be universally incorporated into the daily practice of family physicians. I believe this could help to slowly but surely decrease the obesity epidemic in the United States as well as lower the prevalence of many chronic illnesses including endometrial cancer. It is my hope that this awareness could prevent other families from feeling the devastating premature death of a loved one that my family endured when we lost my grandmother. Future questions to be considered would be how exercise or healthy eating habits could prevent or possibly even reverse the development of endometrial cancer. In addition, it may be also useful to consider these lifestyle intervention programs may have an impact on the quality of life of endometrial cancer survivors.