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What is ‘Cuomo’s paradox’ — and how does it affect people with cancer?

News RoomBy News RoomAugust 28, 2025No Comments3 Mins Read
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What is ‘Cuomo’s paradox’ — and how does it affect people with cancer?
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Finally, some good news for the millions of Americans living with cancer or heart disease.

Experts have consistently warned that drinking alcohol and being overweight significantly increase the risk of developing several cancers and heart disease.

But an observation called “Cuomo’s paradox” suggests that certain factors that increase the odds of chronic disease — like booze or excess weight — can actually be associated with better survival or have no effect once the disease has been diagnosed.

Biomedical scientist Raphael E. Cuomo — for whom the phenomenon is named — said it “turns the rulebook upside down.”

“That same glass of wine or the cholesterol level doctors once scolded you about can, in some patients already fighting cancer or heart disease, sit alongside longer survival,” Cuomo, a professor at UC San Diego’s School of Medicine, told The Post.

“I am not telling anyone to binge on cocktails or butter,” he added, “but the paradox shows we cannot assume yesterday’s prevention goals still apply after a serious diagnosis.”

Here’s an example. Obesity fuels chronic, low-grade inflammation throughout the body, which can damage DNA and promote the development of cancer.

Excess weight also disrupts the balance of several key hormones, encouraging cell growth and proliferation.

“But in cancer patients undergoing cachexia-inducing treatments,” Cuomo said, “starting off with higher body mass can increase likelihood of survival.”

Cachexia, which affects up to 80% of patients with advanced cancer, is a complex wasting syndrome that leads to extensive loss of fat tissue and skeletal muscle.

Cuomo’s paradox doesn’t just cover bad behavior.

“People often think more antioxidants equal more protection, but the landmark trials warn otherwise,” Cuomo said.

“Under Cuomo’s paradox, a nutrient that seems protective before disease can fail to help (or even hurt) once serious illness enters the picture.”

One reason for this is that cancer treatments, such as some forms of chemotherapy and radiotherapy, rely on inducing oxidative stress to kill cancer cells. Antioxidants are designed to reduce oxidative stress.

The findings were published this month in the Journal of Nutrition.

Much still needs to be learned about Cuomo’s paradox, including the extent to which factors like cancer type, stage and treatment influence outcomes.

In the meantime, Cuomo calls it “a real game-changer for precision nutrition.”

He said that healthcare providers should tailor their guidance to individual patient needs, especially if the person has been diagnosed with cancer or heart disease.

“The priority for these patients is surviving their disease,” Cuomo noted, “which involves a distinct strategy that is likely not best served by simply copying the same lifestyle advice that we provide to patients wanting to prevent the development of chronic conditions.”

Still, there is one popular habit that’s likely to be a universal “no” among doctors.

Sorry, smokers, forget that pipe dream.

“Tobacco is an example of a behavior where associated risks are so enormously high that it is unlikely any perceived benefit could ever justify its use,” Cuomo said.

Read the full article here

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