Obesity & Cancer Risk
- Nikki Girvan survived a heart attack at age 45 back in 2019, and was soon after diagnosed with a rare type of blood cancer known as Essential thrombocythemia (ET). Now, years after her health “wake-up call,” the Northern Ireland resident is urging other women to “take action now” and take control of their health, as obesity has been linked to both cancer and cardiovascular issues.
- Essential thrombocythemia (ET) is a rare type of blood cancer in which your bone marrow makes a large number of platelets. Bone marrow is the spongy tissue inside large bones where white blood cells, red blood cells and platelets are made.
- Studies have shown that diet can influence cancer prevention. Heavy alcohol consumption and obesity have been linked to a number of cancers, so it’s a good idea to exercise and maintain a diet that incorporates more fruits and vegetables, whole grains and lean proteins while decreasing sodium and added sugar intake.
- Studies have shown that maintaining an active lifestyle can be helpful for cancer prevention, for patients undergoing chemotherapy and other treatments, and for survivors recovering from treatment.
In a recent interview about her health scare that sparked her to lose weight and take on healthier habits, Girvan told BBC News NI, “At that point, I began thinking of my own mortality and that I could have died.”
"You think it's never going to happen to you, having a heart attack at 45."Read MoreNikki Girvan said she got a wake-up call after having a stent inserted and being diagnosed with blood cancer. Now she says people can make the same changes she did. Read more: https://t.co/FqGgWmqnQQ pic.twitter.com/jzoAcX4Jeh — BBC News NI (@BBCNewsNI) November 16, 2023
Recounting her 2019 health scare, Girvan explained how she started feeling sick on a train from Dublin, prompting her colleagues to call an ambulance.
Girvan said, “I was sweating profusely, having trouble breathing and had pain down my left arm. I knew something was seriously wrong. I was blue-lighted to Daisy Hill Hospital then transferred to Craigavon Area Hospital for heart surgery.”
After having a stent put in her heart, Girvan was diagnosed with cancer just weeks later. However, she admits it took about a year for her to starting looking back on her medical issues and take control of her health. She dubbed her heart attack and cancer diagnosis as “the wake-up call I needed,” adding, “I am a single mum with a full-time job, my son needs me, and I have to take care of him.”
Explaining what led to her change of mind, Girvan told the news outlet, “During Covid, and after the first lockdown, my weight spiraled out of control with eating and drinking and no exercise. Then I thought, ‘My goodness, look at yourself, you really need to do something about this.’
“But it was difficult, as when the mood is low you tend to overeat and drink. I’d become socially reclusive, I couldn’t find anything to fit me, and I didn’t want to go out.”
Following her “wake-up call” Girvan began cooking healthier food and drinks, as well as becoming more physically active with the help of a personal trainer.
Now Girvan insists she’s “full of energy and playing football with my son.”
“I am not breathless and my cholesterol is back to normal. I’m off the statin medication and my blood cancer is under control with treatment,” she added. “My advice to other women is: ‘You can do it and take action now.'”
In Girvan’s video interview with BBC, she added, “You think it’s never going to happen to you, having a heart attack at 45, being diagnosed with blood cancer, but it can happen to anyone. So my advice would be to take action now.”
According to the National Institute of Cancer, “Obesity is a disease in which a person has an unhealthy amount and/or distribution of body fat.
“Compared with people of healthy weight, those with overweight or obesity are at greater risk for many diseases, including diabetes, high blood pressure, cardiovascular disease, stroke, and at least 13 types of cancer, as well as having an elevated risk of death from all causes.”
Understanding Essential Thrombocythemia (ET)
Essential thrombocythemia (ET) is a rare type of blood cancer in which your bone marrow makes a large number of platelets. Bone marrow is the spongy tissue inside large bones where white blood cells, red blood cells and platelets are made.
Here’s how to deconstruct the disease name, Essential Thrombocythemia: The term “essential” means that the problem is primarily due to platelet-forming cells in your bone marrow. Thrombocyte is another term for platelet, thus “thrombocythemia” indicates an increased number of platelets in your blood.
In our body platelets serve a very important function, which is to seal off a leaking blood vessel and control bleeding after an injury or trauma. Too many platelets can make your blood thick and cause problems in the clotting process. There are other conditions that can also increase the platelet count in your body, such as inflammatory conditions or iron deficiency anemia. Your doctor will check your labwork to exclude these conditions before reaching the confirmed diagnosis of ET.
ET is a type of cancer that falls under the category of myeloproliferative neoplasms (MPNs). Dr. Ghaith Abu-Zeinah, an oncologist/hematologist at Weill Cornell Medicine, describes ET as “probably the least aggressive of all MPN subtypes…It’s particularly characterized by an increase in platelet counts without necessarily having an increase in the red cell or the white blood cell counts.”
ET develops when an error occurs in the JAK2, CALR, or MPL genes of your bone marrow cells. ET usually occurs in adults and is more common in women than men. You cannot catch ET from other people. Very rarely, ET can evolve into acute leukemia or myelofibrosis.
Symptoms of Essential Thrombocythemia (ET)
In the early stage of the disease, you may not have any symptoms; a routine blood test at your doctor’s office may show an abnormally high level of platelets.
In general, the common symptoms include:
- Frequent headaches
- Profuse sweating, particularly at night
- Painful, swollen joints of hands or feet
- Symptoms of a blood clot such as pain, swelling, redness, and warmth in the legs or arms
- Unexpected bleeding
One of the major complications you may experience with ET is the development of blood clots. Blood clots can occur in the deep veins of the legs and arms (known as DVT or deep vein thrombosis). These blood clots can break off from the vein and travel to another organ system. Blood clots in the brain (causing a stroke), eyes (causing blindness), heart (causing a heart attack), and lung (pulmonary embolism) are the most dangerous complications of ET. There is no definitive platelet number in your blood that your doctor can predict the risk of thrombosis.
In pregnancy, ET can cause problems in the placenta or fetus. This may affect fetal growth and can lead to a miscarriage.
If your platelet count reaches more than a million, you may also experience abnormal bleeding such as nosebleeds, bleeding from the mouth or gum, blood in the stool or bruises on the skin. It may also take longer for the bleeding to stop after a minor cut or injury.
The Importance of Living a Healthy Lifestyle
The general recommendations for a healthy lifestyle are the same whether you have cancer or not. Dr. Ken Miller, the Director of Outpatient Oncology at the University of Maryland Greenebaum Cancer Center, has some guidelines for cancer survivors who are concerned about a recurrence:
1. Exercise at least two hours a week, and walking counts.
2. Eat a low-fat diet. The Women’s Intervention Nutrition Study, which looked at early-stage breast cancer patients, found that a low-fat diet was associated with reduced risk for cancer recurrence, particularly in those with estrogen receptor-negative cancers. Other studies have found that foods with a high glycemic index that are digested quickly and cause a spike in blood sugar may lead to tumor growth in lung cancer patients.
3. Eat a colorful diet with lots of fruits and vegetables. The American Cancer Society recommends aiming for two to three cups of vibrant vegetables and fruits each day.
4. Maintain a healthy weight. Studies have shown that being obese can increase your risk for several types of cancer.
It’s important to note that healthy diet recommendations for cancer-related concerns can differ depending upon who you ask.
Studies have shown that diet can influence cancer prevention. Heavy alcohol consumption and obesity have been linked to a number of cancers, so it’s a good idea to exercise and maintain a diet that incorporates more fruits and vegetables, whole grains and lean proteins while decreasing sodium and added sugar intake.
Sugar, specifically, has attracted a lot of attention for a possible role in cancer, but overwhelming medical evidence finds that sugar does not cause cancer. SurvivorNet has previously found that credible sources such as Memorial Sloan-Kettering and M.D. Anderson Cancer Center all came to that same conclusion as well.
But there is still some debate on the subject. Dr. Brian Berman, director of the center for integrative medicine at the University of Maryland, believes sugar does, in fact, fuel cancer.
Below we have shared his views not because it is of equal scientific weight to the sources cited above, but rather because it is a view that does get a lot of attention and press.
There’s also articles that often get published saying “this fruit” or “that vegetable” is the magical cure to cancer. Unfortunately, that’s not necessarily the case.
Leading oncologists say it is always hard to use studies of a single food to make sweeping generalizations about their impact on health.
There is a variety of factors that can determine health risk and it is difficult, and perhaps impossible, to say that a single food such as mushrooms can have a direct impact on cancer risk. Many other factors such as overall diet, environmental risk, genetics and exercise play a role.
As for exercise, according to the National Cancer Institute, physical activity is beneficial for cancer survivors. The NCI cited findings from a report of the 2018 American College of Sports Medicine International Multidisciplinary Roundtable on physical activity and cancer prevention and control in saying that exercise is generally good for cancer survivors. The roundtable also found:
- Strong evidence that moderate-intensity aerobic training and/or resistance exercise during and after cancer treatment can reduce anxiety, depressive symptoms and fatigue and improve health-related quality of life and physical function.
- Strong evidence that exercise training is safe in persons who have or might develop breast-cancer-related lymphedema.
- Some evidence that exercise is beneficial for bone health and sleep quality.
- Insufficient evidence that physical activity can help prevent cardiotoxicity or chemotherapy-induced peripheral neuropathy or improve cognitive function, falls, nausea, pain, sexual function or treatment tolerance.
Still, it’s important to note that other experts like Dr. Sairah Ahmed, associate professor in the Division of Cancer Medicine at the University of Texas MD Anderson Cancer Center, say being in good shape during your cancer battle is very beneficial.
In fact, studies suggest that physical activity can be a powerful antidote for side effects of cancer treatment like “chemo brain” and, according to Dr. Ahmed, the more physically fit you are during cancer treatment, the less side effects you’ll have and the faster you’ll get back to your normal quality of life.
“In terms of cancer, oftentimes patients feel that they don’t have any control over any part of their life, and that’s not true,” Ahmed told SurvivorNet in an earlier interview. “Diet, exercise, and stress control are extremely important when going through cancer therapy, as well as once you’re done treating your cancer and trying to get back to the rest of your life.”
Dr. Andrea Tufano-Sugarman of NYU Langone Health also previously spoke to SurvivorNet and explained the benefits of losing weight, saying “While all cancers cannot be prevented, losing weight is a great way to reduce one’s risk.”
And even without losing weight, adopting a more nutritious diet can help. “Food choices, independent of weight loss, may also help to reduce risk,” Dr. Tufano-Sugarman said. “Research has shown that the Mediterranean diet (rich in fruits, vegetables, nuts and legumes, fish and olive oil) is associated with a decreased risk of cancer. Whereas diets rich in red meat may be associated with an increased risk of colorectal and prostate cancer.”
SurvivorNet experts agree that diet and cancer risks are closely related. Overcooked red meat, processed foods like bacon, as well as fatty meats have all been associated with an increased cancer risk.
However, removing these suspected triggers does not always stop cancer from developing, and indulging in them does not necessarily mean a person will get cancer. There is a bit more to understanding cancer risk than that.
We are exposed to carcinogens (substances that can cause cancer) throughout our daily lives, such as when we prepare food. But many people will not go on to develop the disease, according to Dr. Robert Wright, chair of the Department of Environmental Medicine and Public Health at Mount Sinai.
“We create carcinogens all the time in our foods when we cook them, and very few of us get cancer because our bodies can handle them,” Dr. Wright told SurvivorNet in an earlier interview. “But some people have susceptibilities to these environmental carcinogens, which might be genetic or might be caused by combinations of carcinogens.”
It is important to understand that no one trigger is going to definitively cause cancer, Dr. Wright says, but it could be a combination of triggers in the environment.
No matter what anyone tells you, as far as we know, there is no single food that doctors can point to, with absolute certainty, and say it decreases cancer risk. That does not mean that healthy eating habits are not important. When it comes to dietary advice that applies to everyone, Dr. Wright is straightforward saying simply eat more vegetables and stay active.
Contributing: SurvivorNet Staff