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Senior Citizen Health & Medicine
Obesity and Prostate Cancer a Deadly Combination,
Study Finds
More than two-and-a-half times the risk of dying
compared to men of normal weight
 March 15, 2007 - Obese men who are diagnosed with
prostate cancer have more than two-and-a-half times the risk of dying
from the disease as compared to men of normal weight at the time of
diagnosis, according to a study by researchers at Fred Hutchinson Cancer
Research Center. The findings by senior author Alan Kristal, Dr.PH, and
colleagues appear online and will be published in the March 15 print
edition of the journal Cancer.
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"I was very surprised by the findings," said
Kristal, member and associate head of the Cancer Prevention Program in
the Hutchinson Center's Public Health Sciences Division. "We found the
prostate-cancer-specific mortality risk associated with obesity was
similar regardless of treatment, disease grade or disease stage at the
time of diagnosis," he said.
"If a man is obese at the time of diagnosis, he
faces a 2.6-fold greater risk of dying as compared to a normal-weight
man with the same diagnostic profile, regardless of whether he has a
radical prostatectomy or radiation therapy, whether or not he gets
androgen-deprivation therapy, whether he has low- or high-grade disease
and whether he has localized, regional or distant disease," Kristal
said, referring to the degree of cancer spread.
The researchers also found that obese men diagnosed
with local or regional disease — that is, disease that is confined to
the prostate or has spread to into surrounding tissue — face a 3.6-fold
increased risk of cancer spreading into distant organs, or metastasis,
as compared to prostate-cancer patients of normal weight. The
association of obesity with disease progression was strongest among men
with regional stage at diagnosis, whose cancer had already spread beyond
the prostate, as compared to men with early, localized disease.
The mechanisms behind the link between obesity and
prostate cancer metastasis and death are believed to involve both
steroid hormones and inflammation. "We are now beginning to appreciate
that obesity is a massive inflammatory condition," Kristal said, "and
obesity also increases levels of serum estrogens and growth factors that
can promote cancer growth."
For the study, Kristal, first author Zhihong Gong,
Ph.D., a postdoctoral research fellow in the Hutchinson Center's Cancer
Prevention Program, and colleagues at the Hutchinson Center and the
University of Washington followed 752 recently diagnosed middle-aged,
Seattle-area prostate-cancer patients for about 10 years.
Body-mass index, or BMI, in the year before
diagnosis was determined in an initial interview; 17 percent of the
participants were classified as obese, with a BMI of 30 or more.
Of the men studied, 50 died of prostate cancer and
64 died of other causes.
Only one other study has examined obesity and
prostate-cancer outcome; this study reported no association between the
two, but the study was limited to men at one hospital, all of whom
received radical prostatectomy.
Kristal's study is the first long-term,
population-based study of prostate-cancer patients who have undergone a
variety of treatments. A strength of the study is that it used
metastasis and mortality as an endpoint versus biochemical recurrence
(the presence of circulating prostate-specific antigen, or PSA, in the
blood after treatment, a biomarker of limited value in predicting death
from prostate cancer).
"I think this study represents the first good piece
of evidence that losing weight may in fact reduce the risk of dying of
prostate cancer," Kristal said.
"Although one would need a randomized clinical
trial to definitively determine whether weight loss could be an
effective complimentary treatment for obese men diagnosed with prostate
cancer, these results offer yet another good reason for men to achieve
and maintain a healthy weight," he said.
The National Institutes of Health, the National
Cancer Institute and Fred Hutchinson Cancer Research Center funded this
study.
About Source:
Fred Hutchinson Cancer Research Center:
"At Fred Hutchinson Cancer Research Center, our interdisciplinary teams
of world-renowned scientists and humanitarians work together to prevent,
diagnose and treat cancer, HIV/AIDS and other diseases. Our researchers,
including three Nobel laureates, bring a relentless pursuit and passion
for health, knowledge and hope to their work and to the world. For more
information, please visit
www.fhcrc.org."
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