Can Weight Loss Drugs Prevent or Even Treat Uterine Cancer?
Over the past year, drugs like Wegovy, Ozempic, Mounjaro and Zepbound have been making headlines for their ability to help people lose weight seemingly overnight.
Originally prescribed to treat diabetes, the drugs known as GLP-1 receptor antagonists work by increasing stimulation of these receptors in the brain that are responsible for the feeling of fullness, leading to decreased calorie intake and in turn weight loss.
With obesity being linked to more than a dozen types of cancer, can these drugs also be used to prevent cancer?
Monica Avila, MD, a gynecologic oncologist in the Gynecologic Oncology Department at Moffitt Cancer Center, believes that not only can they prevent cancer, they can even be used to treat it.
“Everyone is obsessed with weight loss drugs these days,” Avila said. “What happens when these patients lose all the weight? Does it help the pre-cancer or cancer go away? Does it help keep it away?”
Obesity is the biggest risk factor for women developing uterine cancer, which begins in the lining of the uterus, called the endometrium. The uterus is a hollow organ in the pelvis where fetal development occurs during pregnancy.
Excess body fat can lead to higher levels of estrogen in the body. Estrogen is a hormone that is produced mainly in the ovaries and plays a key role in the menstrual cycle and the growth of the endometrium.
Higher levels of estrogen, especially in women who are not taking estrogen-lowering medications like some forms of birth control, can stimulate the cells of the endometrium to divide more rapidly, which increases the risk of mutations that can lead to cancer.
The standard of treatment for people whose disease is confined to the endometrium is to implant an intrauterine device. According to Avila, 80% to 90% of patients respond well to the device but typically see their disease revert back to either pre-cancer or cancer within six months.
In an effort to combat the problem at the source, Avila collaborates with Lisa Marie Ferreira, MD, an obesity medicine physician with the AdventHealth Medical Group Bariatric Surgery at Tampa.
So what can someone with uterine cancer expect when they are referred for weight loss treatment?
According to Ferreira, they will first receive an initial consultation with an obesity medicine specialist that involves a comprehensive assessment including medical history, lifestyle habits, psychosocial factors, physical exam incorporating body composition testing and relevant laboratory evaluation.
Lisa Marie Ferreira, MD
“We work to develop an individualized treatment plan incorporating nutrition, physical activity, behavioral therapy, pharmacotherapy and bariatric surgery if indicated,” Ferreira said. “Our patients continue to work closely with our obesity medicine specialists to ensure effective and sustainable treatment for the disease of obesity.”
Before referrals for weight loss medications were an option, Avila says diet and exercise plans were recommended for people diagnosed with uterine cancer. Unfortunately, the results typically weren’t sustainable.
“Most of the time we didn’t see any big changes,” Avila said. “It’s really hard to get motivated when the diagnoses may mean you lose your uterus or lose your fertility.”
The hope now is that doctors can turn these drugs once intended to treat diabes to potentially prevent the recurrence of cancer but also prevent the manifestation of cancer.
“It begs the question, could it work as a complete primary preventive strategy?” Avila said. “Can we intervene with weight loss treatment before anything forms?”
Currently there are no clinical trials looking at using GLP-1 receptor antagonists to treat uterine cancer. Avila and Ferreira are hopeful that could change in the near future and unlock new opportunities to help save women’s lives and preserve fertility.
