Researchers at Cedars-Sinai Cancer have made a significant discovery that could change the way colorectal cancer is managed.
They found that fatty liver disease, often found in obese people, may promote the spread of colorectal cancer to the liver.
The Obesity Epidemic and Fatty Liver
In the United States, obesity is a prevalent problem, affecting 25% to 30% of adults. Obesity often brings along fatty liver disease, a condition where excess fat builds up in the liver.
This new study led by Dr. Ekihiro Seki, a professor at Cedars-Sinai, suggests that fatty liver could play a significant role in the spread of colorectal cancer to the liver.
The Study Findings: Fatty Liver and Colorectal Cancer
Dr. Seki and his team noticed that fatty liver cells secrete sacs filled with proteins and genetic material. These sacs encourage the spread of colorectal cancer to the liver.
Even a mild form of fatty liver, often overlooked by clinicians, could increase the risk of cancer spread.
In their study, more than 40% of patients had fatty liver disease. However, many cases might be missed because doctors do not frequently order the specialized MRI required to detect it.
As a result, Dr. Seki urges medical professionals to pay more attention to colorectal cancer patients who might also have fatty liver disease.
Implications for Colorectal Cancer Patients
Colorectal cancer often spreads to the liver. In fact, about 70% of patients with colorectal cancer will develop liver metastasis, a leading cause of death for these patients.
Dr. Seki and his team wanted to understand why this spread happens more aggressively in some patients and why some patients respond better to therapy than others.
They hypothesized that fatty liver could be a key factor.
The Mechanism: How Does Fatty Liver Promote Cancer Spread?
The researchers used laboratory mice with colorectal cancer that had spread to the liver. Some of these mice were fed a high-fat diet that led to fatty liver disease.
They noticed that the liver cells in the mice with fatty liver disease produced more extracellular vesicles – particles carrying proteins and genetic material.
These extracellular vesicles were found to contain three types of microRNA that stimulate cancer growth and spread.
These vesicles are absorbed by cancer cells, and the microRNAs interact with a protein called yes-associated protein to promote tumor growth.
This results in more aggressive and metastatic cancer in mice with fatty liver disease.
Impact on Cancer Treatment and Future Research
This study also suggests that fatty liver disease might make tumors resistant to immunotherapy, a common treatment for cancer.
This resistance could be due to the yes-associated proteins that suppress the immune system around tumors.
Further research is needed to investigate whether fatty liver disease in lean patients, a common occurrence in Asian populations, has the same effect on cancer spread.
Additionally, more studies are required to understand if metastatic colorectal cancer is resistant to immunotherapy in patients with fatty liver disease, and how this resistance can be overcome.
This groundbreaking study offers valuable insights into the role of fatty liver disease in promoting colorectal cancer metastasis.
Dr. Dan Theodorescu, the director of Cedars-Sinai Cancer, emphasized the need to focus on populations at high risk of fatty liver disease, especially those with colorectal cancer.
This research underlines the importance of understanding the distinct tumor microenvironments in patients with fatty liver disease that may affect their response to cancer therapies.
If you care about liver health, please read studies about dairy foods linked to liver cancer, and coffee drinkers may halve their risk of liver cancer.
For more information about liver health, please see recent studies that anti-inflammatory diet could help prevent fatty liver disease, and results showing vitamin D could help prevent non-alcoholic fatty liver disease.
The study was published in Cell Metabolism.
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