Conducted by researchers at the College of Nursing
A study conducted by researchers at Qatar University (QU) Health’s College of Nursing has revealed the complex relationship between metabolically healthy obesity and metastasis in lung cancer patients. The study, addressing a notable gap in existing literature, analyzes the complexities of obesity's impact on lung cancer outcomes. It emphasizes the importance of incorporating comprehensive strategies that recognize metabolically healthy obesity as a crucial factor in patient management and healthcare decision-making for individuals with lung cancer.
Lung cancer, a challenging malignancy with significant global implications, continues to be a leading cause of cancer-related deaths worldwide. With a focus on metastasis, the threatening spread of cancer cells to distant organs, the study revealed alarming statistics about the prevalence and patterns of metastasis in lung cancer patients. This highlighted the urgent need for more comprehensive research to address the challenges posed by this devastating disease. As per the latest data from the World Health Organization in 2020, lung cancer-related deaths in Qatar amounted to 73, constituting 1.79% of total deaths. The age-adjusted death rate stands at 10.46 per 100,000 of the population, positioning Qatar at the 101st rank globally in this regard.
Traditionally, obesity (having too much body fat) has been viewed as an adverse prognostic factor in various diseases; however, the study introduces a paradoxical association with lung cancer outcomes. Several studies have indicated that the inverse association between obesity and lung cancer is primarily observed among smokers, suggesting that smoking may confound this relationship. Some studies suggest that weight loss, resulting from damage to lung tissue over a long period of time and declining lung function, may precede the diagnosis of lung cancer. Additionally, cancer itself can cause weight loss, a phenomenon known as reverse causation. One possible mechanism is that oxidative DNA damage, characterized by the accumulation of reactive oxygen species leading to DNA lesions, may be reduced in individuals with a higher BMI. Furthermore, chromosome damage, a hallmark of genomic instability, has been postulated to be influenced by BMI, potentially impacting lung cancer development. The researchers used a systematic review and meta-analysis approach to bridge a notable gap in the existing literature. While individual clinical trials have offered valuable insights, the need for comprehensive meta-analyses has become evident to synthesize the evidence.
The researchers aimed to identify all relevant studies focusing on the relationship between lung cancer, obesity, metabolic health, and metastasis. They employed a tailored combination of specific terms and phrases related to these crucial topics. The search strategy was refined to include studies published in English without constraints on their publication dates. Moreover, two researchers independently reviewed the identified articles and selected studies meeting specific inclusion and exclusion criteria to explore the link between metabolically healthy obesity and metastasis in lung cancer patients. This rigorous approach aimed to guarantee the inclusion of highly relevant and sound-quality studies.
The researchers concluded with the inclusion of eleven studies (median sample size = 4,791) meeting strict criteria, ensuring a thorough analysis of the subject matter. The researchers revealed that while obesity significantly increases readmissions in lung cancer patients, it paradoxically reduces the risk of surgical complications (13%). In more detail, the researchers found that obese individuals had a lower risk of getting lung cancer compared to people with a normal weight. Additionally, the findings emphasize the significance of obesity as a key factor in patient management and healthcare decision-making, prompting a reevaluation of existing protocols. While metabolically healthy obesity is linked to increased hospital readmissions, it also exhibits a protective effect against surgical complications, highlighting the importance of a holistic view in patient care.
The study faces limitations related to the representation of diverse populations, primarily focusing on a specific demographic. This narrow focus may restrict the applicability of the findings to a wider audience. Dr. Waqas Sami, Assistant Professor of Pre-Clinical Affairs, College of Nursing at QU, commented, “Enhancing the external validity of forthcoming research demands the inclusion of more diverse cohorts, fostering a comprehensive reflection of the population at large. To gain a more detailed comprehension of the link between metabolically healthy obesity and lung cancer metastasis, a heightened emphasis on follow-up or randomized controlled trials, coupled with the application of advanced meta-analysis techniques, is recommended.” Moreover, the study, while establishing an association, prompts further exploration into the underlying molecular and physiological mechanisms. Analyzing these mechanisms through future investigations could yield critical insights, offering a foundation for targeted interventions and a better understanding of the complex relationship.
For more inquiries about this study, please contact: Dr. Waqas Sami, via waqas@qu.edu.qa
About QU Health:
As part of Qatar University, we strive to be recognized as leaders in health profession education, research, clinical care, and community engagement through interprofessional collaboration and partnership.
Our aim is to inspire and empower individuals, ultimately driving excellence and innovation for healthier communities. We launched in January 2017 in line with Qatar’s National Vision 2030 for education and health to address the evolving needs of the country and its healthcare system. Currently, there are five colleges are members of QU Health: College of Health Sciences, College of Pharmacy, College of Medicine, College of Dental Medicine, and College of Nursing.