Obesity and Childhood Cancer

Obesity increases one’s risk for several serious health conditions, from heart disease to cancer. Survivors of childhood cancer who become overweight or obese as adults are at an increased risk of developing an obesity-related cancer. If these survivors were obese as children and carry that obesity into adulthood, they are at even higher risk.

So how does being overweight/obese put you at risk for cancer? Higher amounts of body fat cause chronic inflammation in the body, which has the potential to damage our DNA, and in turn, cause cancer.

At highest risk of obesity are childhood cancer survivors of ALL (Acute Lymphoblastic Leukemia) or those who received radiation, more specifically brain, abdominal, and total body irradiation (TBI). ALL puts survivors at risk for obesity due to the use of steroids during treatment. Radiation to the brain can affect the pituitary and hypothalamus, which regulate the metabolic processes in our bodies. Damage to these areas of the brain can lead to over-eating and weight gain.

According to the National Cancer Institute, adults who are overweight or obese are at risk for developing 13 different cancers: meningiomas, adenocarcinoma of the esophagus, multiple myeloma, endometrial cancer, and cancers of the kidney, ovaries, thyroid, breast, liver, gallbladder, upper stomach, pancreas, and colon/rectum. Approximately 70% of adults over the age of 20 are overweight and of that 70%, approximately 36% are considered obese.¹ In 2013, there were approximately 42 million children worldwide who were overweight or obese. These numbers continue to rise.²

Whether obesity is linked to cancer treatment itself or poor nutritional choices and lack of exercise, it still puts our childhood cancer survivors at an increased risk of cancer in adulthood. So what can we, as healthcare professionals, do to help our patients/survivors lower their risk of obesity and in turn, lower their risk of developing an obesity-related cancer in adulthood? We must educate them!

Educating parents should begin as soon as a child is born. We tend to think babies with multiple leg rolls are just so cute, but what if those cute baby leg rolls turn into an overweight toddler, and so on and so forth? Dietary and physical activity habits develop early on in life and often continue with us as we grow into adults, whether good or bad. Also, when our patients' cancer treatment carries the risk of obesity as a long-term side effect, we must educate the parents about this. Being prepared for the possibility and practicing proper nutrition and exercise may allow them to avoid or at least control the obesity as a survivor.

Obesity, in general, puts every individual at increased risk for cancer in adulthood. Knowing that some childhood cancer treatment protocols increase the risk of secondary cancers makes it more important to tackle the modifiable risk factor of obesity now. These children bravely fought and won, so let's help them be victorious and healthy for the rest of their lives!

References

• Nishtar, Sania. Global Child Obesity Epidemic a Huge Risk For Cancer. www.wcrf.org/int/blog/articles/2015/02/global-child-obesity-epidemic-huge-risk-cancer. Published February 4, 2015. Accessed on March 15, 2018.
• National Cancer Institute. Obesity and Cancer. www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet. Published January 7, 2017. Accessed on March 15, 2018.