Both weight loss medications and bariatric surgery have proven effective in reducing excess weight, but a new study is now exploring their connections to the risk of obesity-related cancers (ORC).
Obesity is already known to raise the risk for various cancer types, not to mention its impact on cancer survival odds. Specific cancers related to obesity include multiple myeloma, meningioma, and adenocarcinoma of the esophagus. Other affected areas include the stomach, liver, bile ducts, gallbladder, pancreas, uterus, ovaries, kidneys, thyroid, and postmenopausal breast cancer, as identified by the CDC.
Researchers from Clarit Health Services in Tel Aviv, Israel performed an observational study involving the medical records of 6,356 obese individuals aged 24 and older with diabetes, specifically those without a history of obesity-related cancers.
Between 2010 and 2018, half of these participants were prescribed GLP-1 receptor agonists (GLP-1 RAS) and made at least six purchases of these injectable medications for obesity and type 2 diabetes within a year. The other half underwent bariatric metabolic surgery (BMS).
After accounting for various factors, the researchers found that ORC appeared in 5.62 cases per 1,000 person-years among surgery patients, compared to 5.89 cases per 1,000 person-years for those taking GLP-1 RAS. This led to a conclusion that the direct benefit of GLP-1 RAS on ORC risk—beyond just weight loss—could represent a relative risk reduction of 41% compared to BMS.
The findings were published in the Journal Eclinical Medicine. “Our results highlight additional pathways aside from weight loss that help lower the risk of obesity-related cancers,” stated Yael Wolff Sagy, Head of Research at Clarit Health Services.
What impact do GLP-1 RAS have on cancer risk?
Niketa Patel, a professor of molecular medicine at the USF Health Morsani College of Medicine in Tampa, noted that chronic inflammation is associated with obesity. She indicated that GLP-1 RAS have been shown to curb inflammation and thereby might reduce ORC risk. However, Patel wasn’t involved in the study.
“The anti-inflammatory characteristics of these drugs tackle several recognized cancer risk factors,” she mentioned. In conclusion, obesity can lead to specific cancers, and treating it with GLP-1 RAS might diminish the risk of such cancers.
Dr. Britta Reierson, the medical director at IncoundWell, highlighted that GLP-1 RAS could possess properties that alleviate cancer risk in multiple ways. “For starters, their anti-inflammatory effects can address many acknowledged cancer risk factors,” she commented, also noting that metabolism improvement from these drugs—like lowering blood sugar levels—helps mitigate cancer risk. Additionally, there are indications that GLP-1 RAS may directly impact tumor growth through immune response modulation and epigenetic changes that can influence gene expression across generations.
Long-term effects of chronic inflammation are concerning as they can cause cellular DNA damage, which is a risk factor for cancer development, according to San Francisco-based Savery, who was not part of the study.
While the study presents interesting insights, it also has its limitations. As an observational study, certain differences between the surgery group and GLP-1 RAS group may still exist despite methodological adjustments. Of note is that most participants were administered liraglutide (Saxenda, Viktuza), with a smaller number taking exenatide or duraglutide.
Though GLP-1 RAS serve as a beneficial aid for those pursuing weight loss, Savery emphasized the importance of maintaining a nutritious diet and regular exercise as key components in cancer prevention and overall health improvement.
Looking ahead, Sagy suggested more extensive studies should be conducted to assess the effectiveness of new GLP-1 RAS, which might yield more pronounced results, noting that the directions appear promising. Nevertheless, further research is essential before GLP-1 RAS can be classified as a cancer prevention strategy. Big, randomized controlled trials are particularly necessary to verify these initial observations and to further clarify the underlying mechanisms at play.
In the meantime, while the role of weight loss is crucial for cancer prevention, adding the anti-inflammatory benefits of GLP-1 could amplify those effects, although it’s too early to say whether these treatments will gain FDA approval for cancer therapy.
