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Is cancer biased by biological sex?

Researchers reviewed data showing male versus female patients experience cancer differently, with different immune responses and side effects.

Image Credit: Photo by Napat Saeng on Unsplash

The leading cause of human death is cancer, which causes nearly 13% of all fatalities worldwide. The World Health Organization’s Global Health Observatory shows that biological males (or people assigned male at birth) account for 56% of cancer-related deaths, while biological females (or people assigned female at birth) only account for 44%. 

Researchers have shown these disparities between biological sexes are not just confined to death rates but are evident in the occurrence, progression, and treatment of cancer as well. For example, females in the US have higher risks of getting breast and thyroid cancers, whereas males are more susceptible to prostate, colon, and stomach cancers. 

Doctors have also found that females tend to have colorectal cancer more on the right side of their bodies, whereas males tend to have it more on the left. Doctors want to know how biological sex influences different aspects of cancer, so they can develop sex-specific treatments for their patients.

A team of scientists from Adichunchanagiri College of Pharmacy in Karnataka, India, recently reviewed research on the role of biological sex in cancer. They explained that sex can impact how cancer propagates at the genetic, molecular, and hormonal levels since every cell in the human body is regulated by its DNA. With the biological sex of every patient, the kind of hormones and enzymes they produce changes, as does the way their body reacts to and metabolizes carcinogens.

They noted researchers in the past have found males and females have different immune responses to cancer and anti-cancer treatments. Females tend to have more robust immune systems that respond more strongly to cancer than males. They suggested this discrepancy could explain why fewer females die of cancer.

They also reviewed data from doctors who treat cancer patients, which showed similar treatments for male and female patients with identical cancer diagnoses also cause different levels of side effects. For example, female cancer patients have higher levels of drug-induced toxicity, infections, nausea, and vomiting during treatment than male cancer patients. They found some anti-cancer treatments can even cause females to develop diabetes.

The researchers concluded cancer behaves differently in male versus female cancer patients. However, despite the discrepancies in immune response and side effects, doctors have not yet customized immunotherapy treatments for different patients based on their biological sex. They suggested the typical “one size fits all” approach to cancer treatments could be better personalized for specific cancer patients. 

They recommended pharmaceutical companies test how new drugs affect male versus female cancer patients during their clinical trials before drugs get approved. They suggested drug companies could use this data to provide better estimates of how much medication male versus female patients should take or how long they should take it. They proposed treatments tailored to each patient’s biological sex would help doctors treat them in a more efficient way with the least amount of side effects.

Study Information

Original study: Sex differences in drug effects and/or toxicity in oncology

Study was published on: January 16, 2023

Study author(s): H.T. Rakshith , S. Lohita , Anvil Preem Rebello , Prakash S. Goudanavar , N. Raghavendra Naveen

The study was done at: Adichunchanagiri University (India)

The study was funded by: None acknowledged

Raw data availability: Not available

Featured image credit: Photo by Napat Saeng on Unsplash

This summary was edited by: Aubrey Zerkle