Semaglutide: A Revolutionary Yet Controversial Treatment

Semaglutide has garnered global recognition for its impressive therapeutic properties. Initially praised for its effectiveness in treating diabetes, this medication has also shown promise in addressing weight management, cardiovascular diseases, and kidney disorders.

A recent study published in JAMA Oncology, a journal under the American Medical Association, highlighted the potential of GLP-1 drugs like Ozempic and Wegovy to decrease the risk of up to 10 different types of cancer. This revelation offers new optimism in the realm of cancer prevention.

The mechanism through which GLP-1 drugs reduce cancer risk is fairly straightforward. Overweight or obese individuals are more prone to developing cancer, and the risk escalates with increasing body weight and the duration of being overweight. Semaglutide aids in weight loss through its unique actions of delaying gastric emptying, suppressing appetite, and enhancing satiety.

According to the Centers for Disease Control and Prevention (CDC), being overweight is linked to several physiological changes, such as chronic inflammation and abnormal levels of insulin, insulin-like growth factors, and sex hormones—all of which can promote cancer. The CDC notes that approximately 40% of new cancer diagnoses are related to being overweight, with 13 types of malignant tumors already associated with obesity.

Researchers at Case Western Reserve University analyzed a large dataset of electronic health records (EHR) and found that type 2 diabetes patients treated with GLP-1 drugs had a significantly lower risk of developing 10 out of the 13 obesity-related cancers compared to those on insulin therapy alone. The cancers with reduced risk included esophageal, colorectal, endometrial, gallbladder, kidney, liver, ovarian, and pancreatic cancers, as well as meningioma and multiple myeloma.

While the risks for breast cancer, thyroid cancer, and gastric cancer did not show significant differences, the study noted that GLP-1 therapy might lower the risk of postmenopausal breast cancer, which is closely linked to obesity.

However, semaglutide is not without its drawbacks. Despite lowering the risk of many cancers, it may increase the risk of others. For example, diabetic patients using GLP-1 drugs might face a higher risk of kidney cancer compared to those taking metformin. Additionally, previous reports suggest that like insulin, GLP-1 injections could be linked to an increased risk of thyroid cancer.

Studies on the side effects of GLP-1 drugs have also raised concerns about semaglutide. One study indicated that using Novo Nordisk's semaglutide injection could heighten the risk of non-arteritic anterior ischemic optic neuropathy (NAION), a rare eye condition that can lead to blindness. Data showed that the likelihood of developing NAION was four times higher in type 2 diabetes patients using semaglutide than in those not using it.

Furthermore, semaglutide injections can cause gastrointestinal symptoms such as nausea, diarrhea, vomiting, constipation, abdominal pain, bloating, and indigestion. These symptoms can negatively impact a patient's quality of life and the efficacy of the treatment.

The phenomenon known as "Ozempic Face" has also attracted attention on social media. This term describes physical changes, such as sunken cheeks, loose skin, and hollow eyes, resulting from rapid weight loss after semaglutide injections. These changes have cast doubt on the drug's supposed "beauty-enhancing" effects. Semaglutide may also lead to muscle loss and functional decline, limiting its effectiveness in weight-loss applications.

In summary, while semaglutide holds promise for cancer prevention in high-risk populations, a combination of dietary changes and exercise may be a more stable and effective weight-loss strategy. As we benefit from semaglutide's capabilities, it is crucial to remain aware of its possible side effects and risks.