By Haleemah Atobiloye, M.A., she/hers, Program Manager
At last year’s San Antonio Breast Cancer Symposium (SABCS), I attended the Spotlight Discussion on Obesity and Breast Cancer session and shared my stance on the subject of obesity and breast cancer. At this year’s SABCS, I was interested in hearing what, if anything, had changed on this matter. My curiosity led me to explore any developments, prompting my attendance at the Overcoming Obesity-Associated Breast Cancer Risk panel session moderated by Abenaa Brewster MD, MHS.”
The first presentation of this panel was titled Breaking the Obesity-Breast Cancer Link: Comparing Diet, Drug, and Surgical Approaches, by Dr. Stephen D. Hursting from the University of North Carolina. The central question being explored by Dr. Hursting was how to disrupt the obesity-cancer connection, comparing the efficacy of diet, drugs, and bariatric surgery. To explore this question, the presentation highlighted findings gathered from several large-scale research reports, such as the American Institute for Cancer Research (AICR) World Cancer Research expert report and the International Agency for Research on Cancer (IARC) Cancer Prevention Handbook. The following are some of my takeaways from this presentation:
Dr. Randy Seeley, from the University of Michigan, was the second presenter on this panel. Dr. Seeley’s presentation was titled Mechanisms for the Effects of Incretin and Dual-Incretin to Produce Substantial Weight Loss. The presentation revolved around body weight regulation, and the pivotal role of the brain in this process. Using himself as an example, Dr. Seeley illustrates that for an average male, the annual caloric intake and expenditure balance out at 900,000 calories, resulting in a stable body weight. He underscores the seemingly small impact of gaining just one pound annually, but stresses its cumulative nature over time.
My key takeaway from this presentation is that, in the United States, the average yearly weight gain per person is approximately one pound. Dr. Seeley draws attention to the significance of this seemingly minor increase, equating it to a 4,000-calorie discrepancy between intake and expenditure. This translates to 11 calories a day, likened to the consumption of a single potato chip. He emphasizes that this daily calorie–intake difference plays a crucial role in determining whether a society leans towards obesity or maintains a lean profile—underscoring the importance of recognizing and addressing these marginal variations in caloric balance.
In the third and final presentation, titled Impact of Exercise on Breast Cancer Outcomes, Dr. Kerry Courneya, from the University of Alberta adds their research findings to into solving the intricate puzzle of obesity-associated breast cancer risk. The presentation shifts the focus towards considering exercise as a breast cancer treatment. According to the presenter, this perspective marks a departure from the conventional approach in research, which primarily addresses exercise from a public health or cancer survivorship standpoint, often prescribing a single exercise regimen for all breast cancer survivors. This is a new field of research, and Dr. Courneya using the limited large-scale randomized controlled trials that pertaining to exercise and breast cancer outcomes, provides insights that show that exercise may improve the response of tumors to drugs, leading to better breast cancer treatment outcomes.
The following are some of the preclinical studies the presenter used to illustrate the potential anti-cancer effects of exercise and to highlight the biological mechanisms through which exercise may influence tumor growth and spread:
Number of Studies
Variability in Responses
Exercise as Mono Therapy
Mechanisms for Improved Responses
I think all three presenters presented insightful data. And I am not disputing the scientific fact that obesity is truly a breast cancer risk. The strategies listed by the panelists which include exercise, a controlled diet, and using novel drugs to induce weight loss leads to a healthier society, are all reasonable stances to reduce the risk of breast cancer and improve treatment outcomes for people living with this disease. However, the data presented throughout all presentations showed that America is an obese country. This means obesity is a breast cancer risk factor and the cause of a myriad of other diseases, and given such, this is a public health crisis. However, the method to address this complex matter is still not talked about enough. This is why one of my main concerns—the same as last year—is inequity.
Obesity, similar to breast cancer, is a complex public health crisis. It is fueled by multiple intersectional causes. For example, how many people have access to a quality fitness trainer? Taking this question a bit further, how many people can afford to pay a fitness and nutritional coach for an individualized lifestyle plan? Food deserts, food swamps, the ongoing climate crisis, economic insecurity, and declining mental and emotional well-being are justice issues that have been linked to obesity in many individuals. This year again, I am reiterating that we need systemic change to address and end not just the obesity crisis but also the breast cancer crisis.