Challenges in the Clinical Treatment of Obese Cancer Patients BY ANAHITA KODALI ’23 Cover image: This graph represents the percentage of the population that was obese in OECD countries (an intergovernmental economic organization with 38 countries in its membership) plus the Czech Republic, Hungary, Mexico, Poland, and Slovakia as of 2005. Even 15 years ago, America had a significantly higher rate of obesity than the rest of the nations. This difference has persisted over time. Image Source: Wikimedia Commons
Introduction Cancer is one of the leading causes of death in the US and presents significant challenges to the healthcare systems of every country. In the US alone, there were about 1,806,590 new cancer cases in 2015 (“Cancer Statistics—National Cancer Institute,” 2015). In 2021, projected estimates for America have slightly increased – there will likely be about 1,898,160 new cancer cases (Siegel et al., 2021). Though the mortality of cancer in the US has decreased in the past 30 years due to advances in clinical and preventative medicine, its prevalence is on the rise and will probably continue to increase over the next several years (Weir et al., 2015). The increase in cancer prevalence may be somewhat puzzling at first glance, given that there have been many advances made in medicine over the past few years and that many risk factors, such as smoking, are becoming less common (“WHO launches new report on global tobacco use trends,” 2019). However, several factors outweigh these positive changes. The first is population growth – as the population grows, more people are alive to be afflicted with disease. Additionally, the world’s
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population is aging. Between 1990 and 2019, the portion of the global population 65 years or older increased from 6% to 9%, and estimates suggest that by 2050, the proportion will have risen to 16% (United Nations et al., 2020). The risk of developing most cancers increases as people get older, though there are ways that people can modify their behaviors to decrease this likelihood (White et al., 2014). Finally, while the prevalence of many risk factors is decreasing, the prevalence of others is increasing; this includes obesity. Obesity refers to the condition in which patients have accumulated abnormally excessive amounts of fat in their adipose tissue. The fat distribution can be varied – some patients have abdominal obesity, in which there is significant fat accumulation in the waist and torso, while others have gynoid obesity, in which there is significant fat accumulation peripherally around the body. There are several health consequences of obesity (regardless of type). For one, it increases the chance of type II diabetes, hypertension, coronary heart disease, stroke, disability, and premature mortality (Ofei, 2005). It also increases risk of several types of cancer: esophageal adenocarcinoma, meningioma, DARTMOUTH UNDERGRADUATE JOURNAL OF SCIENCE
