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The cancerous outcome of obesity

Gynaecologist Nandhini Elumalai explains how obesity can lead to higher risk of breast and uterine cancers in women in the long run

Diabetes, heart disease, strokes, and even poor mental health — trace the symptoms of these conditions and you will find obesity to be a common factor. One of the leading health issues of today, obesity is a contributor to several critical diseases. While many may expect the commonly known blood pressure, cholesterol and such, you may not be prepared for the increase in the risk of breast and uterine cancers. Unfortunately, obesity has become its own pandemic, with worldwide statistics nearly tripling since 1975 (WHO). With so many people exposed to this cancerous risk, there is a lot to uncover between the cause and effect. 

It may help to begin with the basics: what exactly is obesity? Obesity, according to the WHO, is calculated by the BMI or Body Mass Index, offers Dr Nandhini Elumalai, gynaecologist at Fortis Hospital, Vadapalani. The measure of body fat is calculated by height and weight with this system. Those between the score of 25 and 30 are considered overweight and those over that, obese. Despite being a matter of doubt among many, BMI is the best measure that we currently have, she says. 

Obesity poses an issue as early as childhood with kids getting little exercise and being glued to their devices, she shares. “Obesity in the reproductive age can cause a metabolic disorder, one that will onset at around 40-50 years of age. The disorder can affect hormones, especially estrogen. 

An excess of this hormone is, in fact, the culprit for the cancer factors. While estrogen helps you  look young, one’s body should decrease it over time until there is no production during menopause. An increase in the hormone affects the breasts and uterus through peripheral fat. High amounts of this hormone mean an increase of cancer cells, resulting in possible growth in these regions,” she elaborates.

The excess of any hormone in the body is dangerous. Hence, increase of estrogen is a feeder to breast and uterine cancer. The percentage of people with cancer, who also have obesity, has increased from about nine per cent to 26 per cent in the past decade, Nandhini further informs. 

Detecting the issue

A metabolic disorder due to obesity during one’s reproductive age can be the reason for PCOS, PCOD, heavy bleeding and even infertility. It is this long-term exposure of estrogen that can increase the risk of breast and uterine cancer. “People at the age of 45 or so think heavy bleeding is normal but that is not so. At any age, heavy bleeding is a cause for concern. If your period cycle has increased or the sanitary product has to be changed more frequently and the issue doesn’t resolve itself, you should visit a gynaecologist to assess it. This may indicate high levels of estrogen. One, on an average, must bleed 50-80 ml throughout the cycle, no more,” she says. Upon visitation, following a scan of the pelvis, the doctor may take a piece of the endometrial layer for biopsy if the endometrium is thick according to thier premenopausal/ menopausal state to check for uterine cancer. When it comes to breast cancer, one must rely on self examination after periods every month for early detection. If you find a nipple inverted, discharge or a mass, visit the doctor immediately for an ultrasound (in younger women) or a mammogram (in older women). “There is another issue when it comes to obesity in women. If an obese woman has heavy breasts, it is possible that they can miss a small lump, adding to the risk,” she mentions. 

Interestingly, breastfeeding can lower the likelihood of developing breast cancer. “For nine months, you are not getting your period and then, when you are breastfeeding, your breasts are focussed on the milk production and don’t misbehave thus keeping the risk for cancer low. In contrast, women who begin their menses early and menopause late are at a greater risk,” Dr Nandhini claims.

A better lifestyle

Yet, this is a very preventable symptom, she assures. All one requires is a wake-up call to the severity of health issues posed by obesity. “One must address their lifestyle and make targets to lose weight. A regular exercise of, for instance, 20 minutes of brisk walk every day, is vital. Quit smoking and curb consumption of alcohol. Have a good diet and keep track of your BMI (You can do so from your phone nowadays),” she reminds. The earlier one starts, the better. Starting in childhood and teen days will ensure that you have a healthy midlife when you touch the age of 40, says Dr Nandhini.  

Self examination for breast cancer

  • On your back, put your right hand behind your head. With the left hand, press down in small motions around the entire right breast. Use your middle fingers to do so. 
  • Then, stand or sit and check your armpit. Squeeze the nipple to check for discharge.
  • Repeat the process on the left breast. 
  • In the mirror, check for changes in texture of the skin and notice if a nipple has inverted.

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