Obesity is an epidemic disease and correlates with cardiovascular diseases increasing the
overall mortality. However, it has been recently demonstrated that cancer is an unexpected consequence
of obesity. In most of the studies, it is evaluated with body mass index (BMI): high BMI increases
cancer risk and reduces survival of many solid tumors. The main biologic and clinic topics
regarding obese cancer patients are here presented and discussed. Hyperinsulinemia and Insulin-like
Growth Factors (IGFs) are among the most important links between cancer and obesity. However,
adipose tissue (AT) also produces sex hormones, pro-inflammatory cytokines and hypoxia which in
turn promote initiation and progression of tumors. One of the major clinic concern about obese cancer
patients is the risk of chemotherapy-related toxicity. Previous studies showed that obese patients
do not experience significant increased toxicity compared to non-obese patients. Thus, the increasing
incidence and scientific knowledge of obesity should prompt the researchers to study for personalization
of therapy in obese patients with cancer rather than for the simple chemotherapy “depotentiation”.
It has been demonstrated that weight loss reduces cancer risk and can ameliorate compliance
to therapy. Thus, social politics as well as therapies against obesity may impact on cancer risk,
treatment and survival.