Obesity seems to increase the risk of uterine cancer recurrence

Obesity is well known to be associated with uterine cancer.   However, how obesity affects the prognosis of patients with uterine cancer is unknown.   Arem et al studied 1400 women with uterine cancer as part of the National Institutes of Health-AARP Diet and Health Study.  She evaluated the relationship of BMI (obesity) with overall uterine cancer cure rate.    

Compared with women with a BMI in the range of 18.5 to less than 25kg/m(2), the hazard ratios for 5-year all-cause mortality were 1.74 (95% CI = 1.13 to 2.66) for BMI in the range of 25 to less than 30kg/m(2), 1.84 (95% CI = 1.17 to 2.88) for BMI in the range of 30 to less than 35kg/m(2), and 2.35 (95% CI = 1.48 to 3.73) for BMI greater than or equal to 35kg/m(2) (P trend < .001).   In other words, for a patient with uterine cancer and obesity (BMI > 35), she has more than 200% increase risk of dying from the cancer recurrent than the patients with normal weight.  Higher BMI was also statistically significantly associated with poorer endometrial cancer-specific 5-year mortality.

The study concluded that higher prediagnosis BMI (or obesity) increases risk of overall and disease-specific mortality among women diagnosed with endometrial cancer, whereas physical activity lowers risk.

Obesity and physical activity may affect endometrial cancer survival through various pathways. Obesity may cause tumorigenesis and tumor progression through insulin resistance and hyperinsulinemia, increased bioavailability of steroid hormones, and localized inflammation.  My own intake is even after you have completed your uterine cancer treatment, you should continue to lose weight and to increase exercise.

Reference:

Arem H, et al. Prediagnosis body mass index, physical activity, and mortality in endometrial cancer patients.  J Natl Cancer Inst. 2013. 6;105(5):342-9.