Hysterectomy Linked to Higher Risk of Renal Cell Carcinoma (via Sleep Apnea?)

I just happened to come across a study that showed that hysterectomy is associated with a higher risk of developing renal cell carcinoma. Furthermore, undergoing a hysterectomy at an earlier age increases your chances of renal cell carcinoma even more. There was also a small, but significant increase in the rate of bladder cancer. At first glance, this may have nothing to do with obstructive sleep apnea, but once I began to dig a bit deeper into the research literature, here’s how I connected the dots between hysterectomy and renal cell carcinoma:

1. Hysterectomy generally produces surgical menopause. The study didn’t mention what percentage of women also had their ovaries removed, but I’m willing to bet it’s a significant number. Menopause by definition causes sleep disturbances due to a drop in estrogen and progesterone. Progesterone acts as an upper airway muscle dilator, which helps to tense the tongue. Diminishing progesterone allows your tongue to become more relaxed, allowing more frequent obstructions and arousals. This causes less efficient sleep, leading to slow weight gain.

2. Weight gain narrows the throat even further, aggravating or uncovering obstructive sleep apnea. Poor quality sleep also produces vasomotor (or neurologic) symptoms such as night sweats, hot flashes, insomnia, irritability and mood swings.

3. Chronic hypoxia and physiologic stress on the body shunts blood and nervous innervation away from unnecessary body parts and organs when under stress, such as your digestive system, reproductive organs, skin, and your genitourinary system (which also includes your kidneys).

4. Obesity has been shown to be linked to increased risk certain cancers, including the colon, esophagus, prostate, kidney, gallbladder and in women cancer of the breast and reproductive organs. Notice that these are all digestive or genitourinary organs (expect for esophageal cancer, which is mostly due to reflux from apneas).

5. Here are the most common risk factors for renal cell carcinoma: age 50 to 70, obesity, smoking, and hypertension. Notice how all these are risk factors for obstructive sleep apnea as well. We know that nicotine can relax the lower esophageal sphincter, which aggravates more reflux into the throat.

Early menopause has also been shown to increase your risk of heart disease as well. Since we know that untreated obstructive sleep apnea is a major risk factor for heart disease, all these these findings are not surprising.

What do you think about the connections that I’ve made? Please enter your comments in the text area below.

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