Can weight-loss drugs help in cancer treatment? This Jewish organization is on the case

Jamie Mafdali of South Florida was hit with a cancer double-whammy three years ago.

Shortly after her mother began treatment for breast cancer and learned it had metastasized, Mafdali herself was diagnosed with invasive ductal carcinoma in her left breast.

Given her family history, Mafdali, now 45, decided to get a bilateral mastectomy. Although she initially prepared for implants, she later learned of a natural reconstructive procedure known as DIEP flap surgery that she preferred. But it required her to lose at least 20 pounds before her surgeon could even consider the option.

To lose weight, Mafdali’s endocrinologist suggested GLP-1 receptor agonists: a new, enormously popular class of injectable weight-loss drugs known as semaglutides. They’re sold under brand names like Ozempic and Wegovy. 

Over the next year, Mafdali—who’d struggled with weight issues in the past—shed over 20 pounds. 

“I feel satiated with less food and don’t think about food all day now,” she said. “I thought taking a GLP-1 would help me lose the weight needed for surgery, and I’m excited for my next steps along this journey.”

Mafdali spoke at a recent webinar organized by Sharsheret, the Jewish breast cancer and ovarian cancer organization. Sharsheret works to improve the lives of Jewish women and families living with, or at increased genetic risk for, breast or ovarian cancer through personalized support and educational outreach.

Weight-related issues can be a significant complication in cancer treatment, particularly for patients who are diabetic or at risk for diabetes due to obesity.

“People who have diabetes may have an increased risk of complications from breast cancer treatment and possibly also have an increased risk of recurrence,” Dr. Ruth Oratz, an oncologist at NYU Langone Health who sits on Sharsheret’s medical advisory board, said during the webinar. “The treatments we give are often very, very harsh. Chemotherapy can cause a lot of disorders in terms of what you’re eating and how you’re exercising.”

The new GLP-1 drugs are enabling cancer patients to address weight issues more quickly and effectively, helping along their cancer treatments. 

The drugs are also thought to be able to help with lymphedema—swelling caused by an accumulation of fluid from the body’s lymphatic system that can affect arms, legs and other body parts. 

“Lymphedema is not only related to body weight but is also, we feel, sort of an immunologic disease characterized by stasis or stagnation of the lymphatic fluid in the arm after surgery and perhaps radiation therapy,” Oratz said. 

Because the GLP-1 drugs may also have anti-inflammatory properties, Oratz said, they may counteract the slowing down of lymphatic fluid that causes the swelling and inflammation.

“It’s a very exciting time for all these medications,” Dr. Barrie Weinstein, an endocrinologist and the medical director of Well by Messer, a New York City metabolic and wellness center specializing in weight loss, said on the Sharsheret webinar.

Over 800 viewers logged in to watch the webinar, which was facilitated by Melissa Rosen, Sharsheret’s director of training and education, and supported by Pfizer, the Centers for Disease Control and Prevention, and program partners NYU Langone Health, Well by Messer, and the American Jewish Medical Association.

In a recent drug trial, patients who used Wegovy obtained a mean weight loss of 15%, with 36% of patients losing 20% or more of their body weight after two years of treatment. 

Weight loss isn’t the only benefit, Weinstein said. In one recent trial, Wegovy users saw a 20% drop in heart attacks, strokes or death from heart-related events. In another trial of weight-loss drugs known as tirzepatides—marketed under brand names including Mounjaro and Zepbound— patients with obesity as well as a risk for heart disease showed a 38% reduction in hospitalizations for heart failure. Those on the highest dose of tirzepatide saw a 62% clearing of fatty liver compared to those treated with a placebo. 

Another study has shown that Ozempic reduces the risk of kidney failure and death in adults with diabetes and chronic kidney disease. Still other trials indicate that GLP-1 drugs may also slow the degenerative effects of Parkinson’s and Alzheimer’s disease.

“Patients on these drugs feel better and are healthier overall,” Oratz said. “They’ve already shown a benefit in reducing the incidence and risk of recurrence of other kinds of cancers.”

The vast majority of women who develop breast cancer are post-menopausal. Yet Medicare does not cover these drugs to reduce cancer risk. Patients must either have diabetes or metabolic syndrome—or be significantly overweight—in order to get a prescription.

Common side effects of the drugs include nausea, constipation, diarrhea, vomiting and acid reflux. 

Women currently receiving chemotherapy or those with a family history of medullary thyroid cancer should avoid GLP-1 drugs, according to Oratz, and women trying to get pregnant should be off the drugs for at least eight weeks. 

Oratz said that GLP-1s are safe for patients with BRCA-related mutations as well as metastatic breast cancer.

“They’re doing very well, and this has contributed significantly to the stability of their disease by losing weight and correcting the metabolic syndrome,” she said. “There’s no reason why someone who’d otherwise benefit from the drug and has a history of triple negative breast cancer couldn’t take it.”

Sharsheret CEO Elana Silber said part of her organization’s mission is to provide reliable information to the community about new procedures, cancer treatments, and “hot topics” like GLP-1 drugs.

“We know that obesity is one of the biggest risk factors for breast cancer. At the same time, so much of our Jewish culture, holidays, and rituals revolves around food,” Silber said. “If there is a safe and effective option for women to manage weight loss and cancer to improve their quality of life, we want them to know about it from the experts.”

Anyone considering GLP-1 weight-loss drugs as part of a breast cancer treatment plan should speak with their healthcare team to understand the benefits and risks. For personalized support and more information, contact Sharsheret at 866-474-2774 or info@sharsheret.org.