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February is Cancer Prevention Awareness Month. Here at the Abramson Cancer Center, we are committed to providing outstanding comprehensive cancer care and cancer information including ways to prevent cancer. Further, cancer researchers at Penn are at the forefront of learning new ways to prevent and detect cancer.

In this article, we discuss obesity, and how weight increases cancer risk, specifically, being obese. 

It’s no secret that more and more Americans are suffering from being overweight and obese. Perhaps it’s most evident in children, where it is estimated between 16 and 33 percent of adolescents are obese.

How Weight Increases Cancer Risk

Obesity is associated with increased risks of these types of cancers:

• Esophagus
• Breast (postmenopausal)
• Endometrium (the lining of the uterus)
• Colon and rectum
• Kidney
• Pancreas
• Thyroid
• Gallbladder

Also, obesity increases a person’s risk for heart disease, stroke high blood pressure, diabetes, and a number of other chronic diseases.

Several possible mechanisms have been suggested to explain the association of obesity with increased risk of certain cancers:

• Fat tissue produces excess amounts of estrogen, high levels of which have been associated with the risk of breast, endometrial, and some other cancers.
• Obese people often have increased levels of insulin, a condition known as hyperinsulinemia or insulin resistance, which may promote the development of certain tumors.
• Fat cells produce hormones, called adipokines that may stimulate or inhibit cell growth.
• Fat cells may also have direct and indirect effects on other tumor growth regulators.
• Obese people often have chronic low-level, or “subacute,” inflammation, which has been associated with increased cancer risk.

Other possible mechanisms include altered immune responses.

According to the National Cancer Institute:

A projection of the future health and economic burden of obesity in 2030 estimated that continuation of existing trends in obesity will lead to about 500,000 additional cases of cancer in the United States by 2030. This analysis also found that if every adult reduced their BMI by 1 percent, which would be equivalent to a weight loss of roughly 1 kg (or 2.2 lbs) for an adult of average weight, this would prevent the increase in the number of cancer cases and actually result in the avoidance of about 100,000 new cases of cancer.

Lose Weight to Lower Cancer Risk

Maintaining a healthy weight (a weight that falls within a BMI of 18.5-24.5) ranks at the top of the American Institute of Cancer Research’s recommendations for cancer prevention.

The National Weight Control Registry (NWCR) has been collecting data for more than a decade from people who have lost weight and have been able to maintain their weight loss.

They are sharing with us the top six trends that have come out of their surveillance. Nearly 90 percent of the members surveyed by NWCR reported they combined diet and exercise  to lose weight. So dig out your sneakers and get ready to move!

• Exercise. More than 50 percent of NWCR members reported expending 2000 calories a week. Check out AICR’s website for some suggestions of how you burn those calories too.
• Limit TV. Nearly two-thirds of NWCR members reported watching less than 10 hours of TV a week.
• Eat a low-calorie, low-fat diet. NWCR members maintain a similar diet 365 days a year Try filling half your plate with non-starchy fruits and vegetables that pack cancer fighting properties like spinach, broccoli, cucumbers, berries, grapes or melon.
• Eat breakfast. People surveyed said eating breakfast helped curb hunger and grouchiness as well as curb overeating later in the day
• Eat when hungry. Successful dieters from the NWCR maintained their weight loss by eating when they are hungry, not because the cake looked good or because they didn’t want to offend someone by not eating their dish. They also avoid the vending machine because when they are bored or stressed.
• Self monitor. And while you are looking for your sneakers, keep your eye out for your scale and smartphone. More than half of these successful dieters continue to weigh themselves weekly and keep a food journal. There are plenty of free websites and phone apps where you can log the calories you consumed and calories you burned each day.

March is Colorectal Cancer Awareness Month. To learn more about screening, symptoms, treatments and the latest research, we’re teaming up with 6ABC for a live, streaming webchat at 6abc.com/pennmedicine

Colorectal Cancer - Did you know?

You may be at a higher risk for colorectal cancer as you get older, but with education and screening, you can help reduce your risk.

Screening Can Save Lives

For those 50 years and older, getting a colorectal cancer screening can be life saving.

Symptoms like the appearance of polyps in the colon or rectum, persistent stomach aches and pains, rapid weight loss and bloody bowel movements may be key indicators. While these symptoms may be indicative of other ailments, colorectal cancer screenings can help you take the right next steps.

This March, Colorectal Cancer Awareness Month, be sure to ask the right questions, and get the facts.

Our Experts Answering Your Questions

Want to know more about:

• Colorectal Cancer Screening?
• Risk Evaluation?
• Hereditary Risk?
• Cutting Edge Treatment Options?
• New Breakthrough Clinical Trials?
• Survivorship?

James M. Metz, MD is the Vice Chair of the Clinical Division and Department of Radiation Oncology at the Hospital of the University of Pennsylvania, as well as the Associate Director for Clinical Services and Programs at the Abramson Cancer Center, and Najjia N. Mahmoud, MD is the Chief of the Division of Colon and Rectal Surgery as well as an Associate Professor of Colon and Rectal Surgery at Hospital of the University of Pennsylvania.

These Penn Medicine experts will be answering user-submitted questions in a live online chat.

Jill Stopfer, MS, is a certified genetic counselor at the Mariann and Robert MacDonald Women’s Cancer Risk Evaluation Center at Penn’s Abramson Cancer Center. Here she discusses cancer genetic risk, and when is an appropriate time to test children for the BRCA1 or BRCA2 gene mutation.

Women and men with a BRCA1 or BRCA2 gene mutation may have questions about when, and if, their own children should be tested for the same mutation.

Genetic mutations can be passed from generation to generation and it’s important for those with a known BRCA1 or BRCA2 gene mutation to tell their close relatives including siblings, aunts and uncles, parents and adult children. But at what age should you consider testing children for a BRCA1 or BRCA2 gene mutation?

Learning you have a significantly higher chance to develop cancer one day can be scary for anyone – so it is important to consider the value in learning this information for children, teenagers and young adults.

Extensive research in families with known genetic risk due to BRCA1 and BRCA2 has shown that there is no increased risk for cancer in children. Therefore, there are no recommended interventions or special screening methods implemented during childhood. In addition, by choosing to test a child, a parent takes away that individual’s right to decide whether, and when to receive this information. Legally someone can pursue genetic testing for BRCA1/2 mutations at age 18, but it is important to know that even at age 18, screening and follow-up recommendations will not change. This is because the cancer risks associated with BRCA1/2 rarely manifest before the late 20’s or 30’s. So at age 18, national guidelines show there is still isn’t much to do even if a BRCA1 or BRCA2 mutation is present.

At age 25 however, things start to change for young women. Women who test positive for a BRCA1 or BRCA2 gene mutation generally start annual mammography, breast MRIs and breast exams at age 25. Therefore, some find this is an optimal time to consider testing. Young men are sometimes interested in pursuing genetic testing at later ages, since there is no screening that starts for men until later. However, some young men are interested in genetic testing to use in reproductive decision making.

There is no “one size fits all” prescription for genetic testing. Genetic counseling allows each person to understand how they would be affected, and weigh the pros and cons of being testing based on their individual circumstances. Getting tested for a BRCA1 or BRCA2 gene mutation can be overwhelming at any age. Fortunately no one has to go through the process alone.

Genetic counselors at the Mariann and Robert MacDonald Cancer Risk Evaluation Program can provide you with information and support to help each individual make the best decision for themselves about if and when to be tested.

For more information about genetic testing at the Abramson Cancer Center, or to speak with a genetic counselor, call 215-349-9093

Watch the Abramson Cancer Center’s Focus on Your Risk of Breast and Ovarian Cancer Conference to learn more about cancer genetics and risk assessment.

The Basser Research Center to Focus on BRCA1 and BRCA2

The Basser Research Center — BRC for BRCA — supports research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

The Basser Research Center was established with a $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray.


Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

Learn more about the Basser Research Center.

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s Focus On Pancreatic Cancer Conference. In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

Approximately five to 10 percent of pancreatic cancer is considered to be familial, or hereditary.  For those who have a family history of pancreatic cancer or one of several genetically linked syndromes that predispose them to pancreatic cancer, it is very important to identify that risk and get appropriate screening and intervention. 

Anyone who has had at least one parent or sibling (first-degree relative) with pancreatic cancer should meet with a certified genetic counselor to develop a comprehensive family history, and discuss their own risk for developing pancreatic cancer.  A genetic counselor can also help identify conditions such as hereditary pancreatitis that can significantly increase the risk of developing pancreatic cancer, as well as specific genetic mutations that increase the risk of developing other cancers.

The gene mutation BRCA1, for example, is associated with a high incidence of breast cancer, and has also been linked to increases in pancreatic cancer. 

It is important to realize not all risks are equal. By learning family history, every person can understand their own personal risk level. That information can be used to make decisions about screenings and tests as well as medical interventions that may reduce the chance of someone developing pancreatic cancer. 

The Abramson Cancer Center’s Gastrointestinal Cancer Risk Evaluation Program offers complete genetic testing and can provide clinical, genetic and research services for people with concerns about their risk for developing pancreatic as well as other GI cancers.

View the Focus on Pancreatic Cancer Conference to learn more about your risk for pancreatic cancer.

Recent studies have shown alcohol is a leading cause of preventable cancer.

In addition, The World Health Organization has labeled alcohol as the world's third largest risk factor for disease burden, saying it can cause neuropsychiatric disorders and other chronic diseases such as heart diseases, cirrhosis of the liver, and various cancers. It added that 30 percent of cancer deaths are caused by five behavioral and dietary factors, including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use.

But how can drinking alcohol affect a woman’s risk for breast cancer?

According to the American Cancer Society:

The use of alcohol is clearly linked to an increased risk of developing breast cancer.

The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who don’t drink alcohol.