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Metabolic surgery and cancer
Author(s) -
Ashrafian Hutan,
Ahmed Kamran,
Rowland Simon P.,
Patel Vanash M.,
Gooderham Nigel J.,
Holmes Elaine,
Darzi Ara,
Athanasiou Thanos
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25738
Subject(s) - medicine , metabolic syndrome , obesity , cancer , adipokine , diabetes mellitus , weight loss , insulin resistance , hormone , bioinformatics , endocrinology , oncology , physiology , biology
The worldwide epidemic of obesity and the global incidence of cancer are both increasing. There is now epidemiological evidence to support a correlation between obesity, weight gain, and some cancers. Metabolic or bariatric surgery can provide sustained weight loss and reduced obesity‐related mortality. These procedures can also improve the metabolic profile to decrease cardiovascular risk and resolve diabetes in morbidly obese patients. The operations offer several physiological steps, the so‐called BRAVE effects: 1) b ile flow alteration, 2) r eduction of gastric size, 3) a natomical gut rearrangement and altered flow of nutrients, 4) v agal manipulation and 5) e nteric gut hormone modulation. Metabolic operations are also associated with a significant reduction of cancer incidence and mortality. The cancer‐protective role of metabolic surgery is strongest for female obesity‐related tumors; however, the underlying mechanisms may involve both weight‐dependent and weight‐independent effects. These include the improvement of insulin resistance with attenuation of the metabolic syndrome as well as decreased oxidative stress and inflammation in addition to the beneficial modulation of sex steroids, gut hormones, cellular energetics, immune system, and adipokines. Elucidating the precise metabolic mechanisms of cancer prevention by metabolic surgery can increase our understanding of how obesity, diabetes, and metabolic syndrome are associated with cancer. It may also offer novel treatment strategies in the management of tumor generation and growth. Cancer 2011. © 2010 American Cancer Society.