Background:
With increasing cancer survivorship, understanding the risks and predictors of secondary primary malignancies (SPM) has become paramount. Our private oncology practice data revealed intriguing patterns that suggest a potential link between obesity and the occurrence of SPM, notably gastrointestinal (GI) malignancies.
Methods:
We retrospectively analysed 30 patients who developed SPM after achieving remission from their initial cancers. Patients' demographics, body mass index (BMI), type of first and second malignancies, and other relevant factors were recorded.
Findings:
The cohort had a mean age of 79 years; two-thirds were male. Strikingly, 22 patients were overweight, with 11 being morbidly obese. The predominant first malignancy was prostate cancer (n=10), followed by breast (n=5) and urothelial cancers (n=5). Among the SPMs, GI cancers were the most prevalent (n=8), trailed by lung (n=6) and melanoma (n=5).
Discussion:
Our findings raise the suspicion of a significant association between obesity and the development of SPM, particularly GI malignancies. Given that 73% of our cohort were overweight or obese, this correlation warrants comprehensive research. The elevated incidence of GI cancers as a second malignancy could suggest shared aetiopathogenic pathways related to obesity, such as chronic inflammation or insulin resistance.
Conclusion:
Patients cured of primary cancers, especially those overweight or obese, might represent a distinct population susceptible to SPMs. It is essential to consider tailored surveillance and interventions for these survivors. Additionally, a larger-scale study exploring the genetic predispositions, coupled with obesity, might uncover novel insights into mechanisms predisposing this cohort to secondary cancers, guiding future preventive strategies.