Jan 12 2004 Obesity Linked to Aggressive Recurring Prostate Cancer
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Weight, Lower Prostate Cancer Risk Obesity Linked to Aggressive, Recurring Prostate Cancer Source: http://my.webmd.com/content/article/78/95931.htm Dec. 23, 2003 -- A new study shows obese men are more likely to have aggressive prostate cancer that is more likely to recur after surgery. It's a
red flag to men: Two new studies, both in the February 2004 Journal of Clinical Oncology (available online), examine this relationship between obesity and prostate cancer recurrence. "Men from Western cultures, and especially black men, are known to have significantly higher [prostate cancer] incidence and death rates," writes researcher Christopher L. Amling, MD, an urologist with the Naval Medical Center in San Diego. However, studies indicate that obesity -- rather than race or ethnicity -- might make the difference, says Amling. "Dietary fat intake has been consistently associated with [prostate cancer] risk and some studies suggest that higher consumption of red meat in particular may promote development of more aggressive disease," he writes. The EvidenceIn their study, Amling and colleagues analyzed medical records for more than 3,100 men with prostate cancer who underwent radical prostatectomy surgery to have their prostate removed. They found:
These findings support the theory that obesity leads to more aggressive tumors; they also show that BMI may account, in part, for the racial differences found in prostate cancer risk, according to the researchers. The second study showed that severely obese men were much more likely to have a rise in their prostate-specific antigen (PSA) levels after prostate cancer surgery -- indicating that the prostate cancer has come back, writes researcher Stephen J. Freedland, PhD, with Johns Hopkins School of Medicine. In his study, Freedland looked at medical records for more than 1,100 men with prostate cancer -- including 22% who were obese. Severely obese men -- with BMI of 35 or greater (the equivalent of a 5 foot, 10 inch man weighing 245 pounds) -- had a 60% increased risk of cancer recurrence within three years. Men with a BMI between 30 and 35 appeared to have a slight -- although not significant -- increase in prostate cancer recurrence. The MechanismWhile researchers don't completely understand how obesity triggers aggressive tumors, they have several theories, writes Amling. Obesity can increase the amount of active testosterone in the blood, according to Amling. Testosterone and other male hormones have been implicated as a potential cause of prostate cancer. Also, obese men have higher levels of certain proteins and hormones -- such as leptin and insulin-like growth factor-1 -- that may promote prostate tumor growth, he explains. It's estimated that 30% of the American population is obese. Identifying obesity as a risk factor for aggressive prostate cancer is important, since it may be one of the few modifiable risk factors for prostate cancer, says Alfred J. Neugut, MD, PhD, an epidemiologist with Columbia University's Herbert Irving Comprehensive Cancer Center. Neugut wrote an editorial accompanying the two studies. The number of men surviving prostate cancer is steadily increasing. It will be important to investigate if weight loss and other lifestyle changes can improve prognosis in [men] already diagnosed with prostate cancer," Neugut says. SOURCES: Freedland, S. Journal of Clinical Oncology, Feb. 1, 2004: vol 22. Amling, C. Journal of Clinical Oncology, Feb. 1, 2004: vol 22. News release, American Society of Clinical Oncology.
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