Ramón Salazar
Head of Medical Oncology at the Catalan Institute of Oncology (ICO), head of the Colorectal Cancer Research Group, Oncobell programme (IDIBELL) and associate professor of Medicine at the University of Barcelona
It is a very high quality study that identifies a mechanism of action (in a mouse model) that could explain why obesity is a risk factor for the metastatic spread of solid tumours, in this case, triple negative subtype breast cancer.
Obesity and high-fat diets appear to play a complex and often cancer-type specific role in influencing the risk of metastasis in patients previously treated for localised cancer. Although both factors are generally associated with an increased risk of metastasis in breast, prostate and colorectal cancers, the underlying mechanisms involve intricate interactions between inflammation, hormonal changes and alterations in the tumour microenvironment.
Interestingly, the ‘obesity paradox’ observed in certain types of cancer, such as lung cancer, renal cell carcinoma and melanoma, where obesity is associated with better survival, highlights the need for a more detailed understanding of these relationships.
Given the evidence, weight control and the adoption of a healthy dietary pattern, characterised by a high consumption of fruits, vegetables and whole grains, together with a limited consumption of red and processed meats and saturated and trans fats, remain important considerations for survivors of localised cancer.
Recent research also suggests a possible role for antiplatelet and anticoagulant therapies, particularly aspirin and low molecular weight heparins, in the prevention of metastasis in certain types of cancer. However, further research is essential to fully understand their mechanisms of action, identify the patient populations that would benefit most and determine the optimal and safest ways to use these therapies.