Obesity is a problem that affects almost 50 percent of all Americans. The 2007-2008 National Health and Nutrition Exam Survey showed 68 percent of Americans over the age of 20 were overweight or obese. This is an increase from the 1988 survey, which found 56 percent were overweight or obese.
Obesity and the risk of cancer have been associated with the following cancers:
- Esophagal
- Pancreatic
- Colon
- Rectal
- Breast
- Endometrial
- Kidney
- Thyroid
- Gallbladder
Associations between obesity and co-morbidities are as follows:
- Diabetes
- All cardiovascular diseases (except congestive heart failure)
- Asthma
- Gallbladder disease
- Osteoarthritis
- Chronic back pain
Obesity by the numbers:
- Every pound of fat requires one mile of blood vessels
- To lose one pound of fat, a person must burn 3,500 calories
- To lose 10 pounds of fat, a person must burn 35,000 calories
- Ten pounds of muscle will burn 3,500 calories a week
- A pound of fat is about the size of a softball
- A pound of muscle is the size of a baseball
Let's face it, no nurse wants to take care of 400 to 600 lb. patients. Not only is the patient heavy, but basic care takes much longer and often requires a multitude of people just to provide it. The risk of injury to the patient and the nursing staff is also increased.
Obese cancer patients will do worse with surgery, radiation, and chemotherapy. Given that most chemo drugs are calculated by BMI or BSA, obese patients require higher doses. Care of obese patients in the hospital setting can be challenging. These patients often require specialized equipment such as "big boy" beds and oversized bedsides, commodes, and wheelchairs. Transferring obese patients also requires special equipment like the Hoyer lifts and Hover mats. I once cared for a 500 lb. patient who crushed the plastic bedpan. We had to special order him a metal bedpan.
It should also be noted that solid tumors are often less obvious in obese patients. This will often lead to a delay in finding the tumor, allowing the cancer to become more advanced.
So who better to find a treatment for obesity than oncologists? Here at M D Anderson Cancer Center Dr. Renata Pasqualimi and Dr. David Koch may have done just that.
Most diet treatments aim at decreasing appetite and/or stimulating the metabolism. Adipotide works quite differently. It binds to a protein on the surface of specific blood vessels that support fat cells and has a synthetic peptide that will trigger cell death. With no blood supply to feed it, the fat cell dies. Blood vessels, it appears, are more than just a delivery system for blood and nutrients. They differ depending on organ or tissue. That is why this drug is so effective. It is designed specifically for blood vessels to white fat adipose tissue.
In a study using Adipotide on rhesus monkeys, the obese monkeys saw an 11 percent weight loss in four weeks. Abdominal fat levels fell 27 percent. It was also found that their need for insulin dropped 50 percent. After the study end, the weight loss continued for three more weeks. Renal side effects were all temporary and reversible.
Now, before anyone goes racing to their doctors for a prescription, it's still in the testing phases. Nor can you beg Dr. Pasqualimi for the drug (yes, we tried). Human trials will be starting shortly. The first clinical trial will be on obese men with prostate cancer.
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