What Does Your Scale Say About Your Cancer Risk?
January 26, 2020
Losing weight when you're not trying to has long been seen as a possible sign of cancer, says Jordan Winter, MD, Chief of Surgical Oncology at UH Seidman Cancer Center. But surprisingly, he says, there hasn't been much research on the issue. And unintentional weight loss has never been proposed as a potential cancer screening tool. Unintentional weight loss is defined as a loss of more than 5 percent body weight over six to 12 months.
“There are just 12 studies showing that unintentional weight loss is associated with cancer, which I found astounding," he says.
The first effort is to analyze the medical records of UH patients with pancreatic cancer, looking to see if weight loss of 5 percent or more preceded the diagnosis. Unlike the previous research on weight loss, this study relies on actual weight data extracted from the patient electronic medical record – not patients' self-reported recollections.
So far, results are as expected, Dr. Winter says. Among all pancreatic cancer patients studied, 70 percent had weight loss before their diagnosis. For patients with early-stage cancer, the number was 57 percent; for advanced disease, it was 80 percent.
“We are the first to demonstrate weight loss associated with pancreatic cancer with raw weight data," Dr. Winter says.
To help prove that it's the cancer causing the weight loss, Dr. Winter and the team are also running the same analysis for a group of Family Medicine patients who don't have cancer. The group eventually wants to analyze all cancer patients at UH to see if the link between unintentional weight loss and cancer holds up.
“We're in the process of getting those data," Dr. Winter says. “But the more important question is if this phenomenon is really happening, what are we going to do about it? Is there actually something we can do about it?"
That's where the second part of the pilot study comes in. The research group is testing whether non-cancer patients will agree to weigh themselves weekly and text their weight to the study team.
“We're trying to see if prospectively tracking unintentional weight loss, identifying it before the patient is diagnosed with cancer, can be a novel early detection marker of undiagnosed malignancy," Dr. Winter says.
Initial results suggest that this a promising approach, and that patients will actually do it. Of the 50 patients in the feasibility study, 86 percent have recorded one weight, and at about halfway through the study, 75 percent of all possible weights have been logged.
Beyond mere participation, this approach is also detecting weight loss.
“About 6 percent of patients have lost more than 5 percent of their weight," Dr. Winter says. “That's higher than expected because unintentional weight loss occurs in 5 percent of people per year. Two of the patients were trying to lose weight, but one of the patients Dr. Rao's actually quite concerned about and is going to work up."
Possible New Screening Method
Ultimately, Dr. Winter and the team hope to test this weight-loss screening approach in a population-based study with thousands of people. If validated, he says, it could be a significant improvement over current cancer screening methods.
“For the majority of cancer types, there are no good early detection tests," he says. “The ones that exist are actually old technology. Approved early cancer screening, when you do it, occurs at yearly intervals or longer. That's a very long interval to try to detect a cancer that has a mortality in many cases that's less than a year. It's really suboptimal."
“Helping to seed and accelerate the novel research being conducted by our own clinicians and investigators is critical to our collective success," adds David Sylvan, Executive Director, UH Ventures. “We believe the investments UH Ventures makes in our own thought leaders' ideas and initiatives will spark the scalable innovations needed to transform patient care."
Plus, there's this to consider: If weekly weight tracking reveals unintended weight loss that doesn't turn out to be cancer, it still has no real downside. But it may have identified another problem that needs medical attention.
“If you have unintentional weight loss, it may not be cancer driving it, but it's still something you need to see a doctor about," Dr. Winter says. “It's an important sign to address and diagnose regardless of the underlying cause. But in about 20 percent of cases, it may be a low-cost, non-invasive, universal screening method detects a previously hidden malignancy. That could be huge."
Integrative oncology services at University Hospitals Seidman Cancer Center provides patients with evidence-based, holistic therapies to promote optimum health of mind, body and spirit. Learn more about integrative oncology services at UH Seidman.