Relationship between mini gastric bypass and esophageal cancer

Obesity is a modifiable factor that is related to many diseases, including cancer. Could there be an increased risk of developing cancer after a mini gastric bypass?

Obesity is said to contribute 9.4% to cancer in women and up to 4% in men. In fact, multiple studies have shown that patients with obesity have their system altered so that it is very easy for them to get cancer if many more factors join them.

Bariatric surgery has advanced considerably, and today it is considered a genius to reduce obesity and give patients quality of life. For this reason, many patients have made the decision to undergo bariatric surgery to improve their health.

Is there a relationship between esophageal cancer and mini gastric bypass?

The answer is yes.

Performing bariatric surgery brings with it many changes that go beyond just losing weight. These types of surgeries involve modifications at the mental, social, physical and, above all, hormonal levels.

Performing a mini gastric bypass brings with it profound changes in the way food passes through the intestine. Intestinal transit is greatly modified, something that does not happen during a vertical gastrectomy, better known as the Gastric Sleeve.

These profound changes bring with them inflammatory processes that in the long term increase the risk of cancer in the digestive system, especially in the esophagus. The relationship is found in the inflammatory processes that the body must go through as a method of defense against the “trauma” that mini gastric bypass surgery entails.

The body must overcome the procedure and gradually adapt. Therefore, always try to inflame and then begin to heal and fully adapt to the changes made. Although esophageal cancer is not as named as other types, nevertheless, among patients who undergo mini gastric bypass, a relationship has been found due to the high incidence.

At least 10-14 years after surgery, people often develop esophageal or colorectal cancer. For this reason, the studies were carried out for a long time and the relationship was always tried to be clearly established.

Reasons

The literature has been able to provide an answer to the causes of esophageal or colorectal cancer in patients undergoing bariatric surgery. As previously mentioned, the research doctors conducted the study for a long time because the cancer manifested itself long after surgery. It was necessary to wait at least 10 or 14 years before seeing if the patient developed the pathology or not.

Regarding esophageal cancer, we must talk about how there is a link between acid and bile reflux together with esophageal cancer. It may even go undiagnosed before it is in an advanced state. Bile reflux can go to the stomach thanks to the pyloric valve that connects the stomach with the duodenum.

When there is bile reflux, the valve does not close properly and bile can flow into the stomach. This is also related to esophageal cancer because stomach acid causes it to reflux into the esophagus. Here, the sphincter that is modified is the lower esophageal sphincter, when it weakens, bile and stomach acids constantly reach the esophagus, causing inflammation and generating cancer in the long term.

The mini gastric bypass are one of the most frequent causes because the stomach is reduced and the acid produced reaches the esophagus in greater quantity.

Also, the inflammatory process that the body undergoes to deal with surgery is not the only reason that the chances of getting cancer are increased.

There are two main mechanisms. The first is the change in the intestinal microbiome that makes the enzymes and acids much more harmful due to said alteration. In addition, there is also the fact that the distant colon is much more exposed to secondary bile acids due to the anatomical modifications made during the mini gastric bypass.

These two mechanisms are responsible for people being more likely to develop cancer in their digestive system. Still, it is well known that some oncologists also take into account the endocrine disruption that comes with obesity, bariatric surgery, and cancer. Sex steroids can be increased as can inflammatory cytokines that alter the metabolic regulations of insulin.

On the other hand, there are also possible tumors by direct association that can metastasize. Although obese people already have a chance of suffering from cancer, but by having bariatric surgery, they can activate other types of systems that increase the proliferation of malignant cells in the body.

So, is the effect of mini gastric bypass good or bad?

The answer is: it depends.

Although, we have just exposed the different reasons why some patients usually develop esophageal and colorectal cancer after undergoing bariatric surgery. Even so, this does not mean that by doing one of these surgeries you will be signing your death sentence. The truth is that, in most cases, patients do not develop cancer at any time in their lives.

Mini gastric bypass surgery can give you a great quality of life and also has a considerable percentage as a risk-reducing agent for cardiovascular diseases and also cancer itself. The mere fact of eliminating the patient’s obesity causes this carcinogenic risk factor to decrease and the body can continue to work normally.

For every 20% reduction in leptin, the chance of having cancer is also reduced by 20%. In addition, the fact of having decreased levels of fasting glucose, insulin and even C-peptide, all related to diabetes and increased ghrelin, the hunger hormone, are associated with a lower risk of cancer in these bariatric patients.

Those who have severe obesity go to bariatric surgeries and try to find an answer for their definitive life change. This is why this type of procedure is done so often and is recommended by many people based on their experience.

But what determines that esophageal cancer develops after bariatric surgery?

This continues in studies. The deciding factor for that small percentage of patients who develop esophageal or colorectal cancer has not been determined, and is even considered somewhat random or difficult to track. However, hereditary factors, exposure to radiation, among other aspects, are associated.

Conclusion

Like all surgeries, the mini gastric bypass has its advantages and disadvantages. Whether or not to develop cancer will depend on many factors that can be studied and, in most cases, will even be independent of bariatric surgery.

We suggest you consult with your bariatric surgeon, so you can make the right decision. It is a totally personal process that must be respected and understood by all those who surround you and love you. Keep in mind that the benefits are usually much greater than the disadvantages.