How could I have missed obesity as a risk factor for multiple myeloma?

Note: This column describes the author’s own thoughts about GLP-1 agonist medications. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

Every once in a while, you come across something that changes your understanding of something. For me, that came in an article about a new study on GLP-1 agonists and cancer.

GLP-1 stands for glucagon-like peptide-1. You may know these treatments by their brand names — Zepbound, Mounjaro, Ozempic, and Wegovy. They’re used to manage blood sugar and help with weight loss. A report in the Annals of Oncology says their use is also “associated with a significantly lower short-term incidence” of 13 cancers, including multiple myeloma.

But that’s not what stopped me cold. The report also says those 13 cancers are “obesity-associated.” Wait, what? Myeloma is obesity-related? Why didn’t anyone tell me this?

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A risk factor for myeloma

I started digging into this and couldn’t believe I’d been ignorant of the connection. The line has always been, “We don’t know what causes myeloma.” The American Cancer Society (ACS), my first resource after my diagnosis, says the cause of myeloma is not always clear. But in looking for a cause, I overlooked risk factors. ACS does list excess body weight as a risk factor for myeloma.

I suppose it’s proof that doing your own research on medical matters can give you an incomplete picture. It’s not “new” news; the link was established years ago. Somehow I just never came across that particular bit of information, and it’s something my doctors never brought up once I was diagnosed.

Maybe it’s just as well. Treatment was enough to deal with back then. I didn’t need to top it with guilt over my weight problems. And while being overweight may have increased my risk, I still don’t know the actual trigger for my cancer.

What the research says

The study that shook my perception followed people taking GLP-1s for obesity, not diabetes. While it’s a large study, it was also short term; the patients were followed for a median of two years. Researchers found a 41% lower incidence of cancer in GLP-1 recipients compared with patients treated with diet or exercise. They also noted that there was a lower cumulative cancer incidence in patients taking tirzepatide (Zepbound, Mounjaro) compared with patients taking semaglutide (Ozempic, Wegovy). However, more studies with longer follow-up periods are needed.

Still, that research is all about risk reduction. For me, it’s like locking the barn door after the horse is gone. The cancer is here. Can a GLP-1 help me now? Another study says yes!

That study was presented at this year’s annual meeting of the American Society of Clinical Oncology. The researchers call it a real-world comparison of obese myeloma patients who received GLP-1s versus those who did not, followed over five years. They found lower mortality rates in the GLP-1 group, along with lower rates of heart attack, stroke, and other health problems.

So should we rush to our doctors for GLP-1s? Well, this study also notes that more research is needed. These treatments have their own risks, and they can be quite costly. Still, it’s tempting. Especially when I look in the mirror. I’m thinking about it, anyway.

Note: Rare Cancer News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Rare Cancer News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to rare cancer.