High estrogen and insulin associated with breast cancer growth in diabetes & obesity

High estrogen and insulin associated with breast cancer growth in diabetes & obesity

[Rhonda]: I was reading, I think it may be
the American Cancer Association had published some statistics on how obesity can increase
the risk of breast cancer by twofold. And also, specifically looking at some of
the mechanisms by which obesity can increase breast cancer risk. There were a variety of them including increased
inflammation, increased hormone to estrogen, and also increased fasting insulin levels. [Ruth]: Mm-hmm. Yes. I think we’ve known for a long time about
sex hormones in particular, estrogen is a risk factor. Because some of our first really successful
drugs were based on blocking the action of estrogen. Estrogen is a growth factor so it appears
if we can block that, it can reduce your risk or reduce your risk of recurrence. And we have some pretty effective drugs that
have made a big difference. It’s more recently that we’ve realized that
other growth factors have the same type of impact, and it makes…it’s almost common
sense. If estrogen is a growth factor and that increases
growth rates of tumors, well, what about insulin? It’s also a growth factor, it encourages metabolism. So we do believe that perhaps high levels
of circulating insulin may be really central to the whole process of developing breast
cancer and promoting its growth. And high levels of insulin are definitely
found in women who are overweight, if you’re less physically active, and then of course
among diabetics often have high circulating levels of insulin. So we do…are becoming more aware that sort
of that may be kind of a common road where many different syndromes lead to the risk…increased
risk of breast cancer. [Rhonda]: And so you mentioned that people
that are overweight and people that are obese have higher circulating insulin levels. They also have higher circulating estrogen
levels, right? So does fat can secrete? Is it…am I right, fat can secrete estrogen,
or is that something that… [Ruth]: Fat can…yes. So that’s pretty central. And then, what we also know is that people
who have high levels of insulin have lower levels of serum-hormone binding globulin,
something called SHBG which binds estrogen. So it can prevent it from being active. So they seem to be related, they’re not just
two independent pathways, they actually play off each other. [Rhonda]: Interesting. And you say…you brought up something that
was very I think important, and that is you said that these growth factors, they promote
the growth of tumor cells, of cancer cells. [Ruth]: Right. That’s in a very general way. [Rhonda]: Right. [Ruth]: Right. [Rhonda]: Yeah, so you’re… Something, you know, something’s causing the
initial damage, the cells become damaged and, you know, we have a lot of mechanisms inherent
in our cells that can sense damage and say well, okay, I’m going to die, I’m going to
kill myself because if I don’t, may potentially lead to, you know, a cancer cell. [Ruth]: Right. [Rhonda]: But if you have all these growth
signaling factors happening in the presence of that damage, it’s sort of saying, “Hey,
no, no keep going, keep growing, don’t die. Grow, grow, grow. [Ruth]: Yes. [Rhonda]: And, you know, so that’s sort of
like I think the combination between things that are causing the damage which possibly
high inflammation, so obesity also is associated with high inflammation and then, you know,
the combination of the inflammation and the high insulin, the high insulin like growth
factor, the high estrogen it’s sort of like this detrimental combination of damage and
growth signals to allow them to survive.


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