Bariatric Surgery Safe For Patients With A History Of Cancer

Weight-loss surgery is a safe option for patients with a history of cancer, according to a new study by researchers at the West Penn Bariatric Surgery Center, presented today at the 25th Annual Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS.)

The study examined data on 1,500 patients who underwent bariatric surgery at The Western Pennsylvania Hospital from July 1999 through February 2008. Of those, 55 patients either had a history of malignancy prior to bariatric surgery, had a malignancy detected during surgery or pre-screening, or developed a malignancy post-surgery.

The researchers examined the patients at 22 months post-surgery and found that of the 36 who had a history of cancer, three had developed secondary malignancies or metastatic disease. Thirteen patients with no history of malignancy developed cancer post-surgery.

Cancer was detected in four patients during the pre-screening workup, including two patients, neither of whom had previously undergone a colonoscopy, who were found to have rectal cancer. Cancer was detected in two additional patients during surgery.

"As bariatric surgery is becoming one of the most commonly performed surgeries in the U.S., it's likely more and more patients with a history of malignancy will seek weight-loss surgery," said Daniel J. Gagne, MD, lead author of the study and Director of Bariatric Surgery and Laparoscopic and Minimally Invasive Surgery at West Penn Hospital. "A previous history of malignancy does not seem to contraindicate bariatric surgery as long as life expectancy is reasonable and the appropriate follow-up has been made."

"One could argue that weight loss may reduce the risk of subsequent cancer treatment as the patient's weight-related illnesses improve," Gagne said. Obesity is a risk factor for cancer and is associated with increased mortality from a number of malignancies.

The decision on when to undergo bariatric surgery following cancer treatment should be based on issues such as the stage of malignancy and risk of recurrence, and decided in consultation with the patient's oncologist.

West Penn bariatric surgeons routinely request that all patients evaluated for weight-loss surgery undergo appropriate cancer screening as recommended by the American Cancer Society.

Other current and former West Penn surgeons who participated in the study are Pavlos K. Papasavas, MD; Majed Maalouf, MD; Jorge E. Urbandt, MD, and Philip F. Caushaj, MD.

Gagne also taught two courses at the ASMBS conference, June 16-19: "Revisional Surgery - Who, What, Where and Why" and "Perioperative Issues and Early Postoperative Care."