Prostate cancer and obesity: a high risk association

Recent studies emphasized the negative influence exerted by obesity on the risk to develop prostate cancer, the diagnostic and the recovery after surgical treatment.

A meta-analysis of 25 prostate cancer studies over a 14 years period detailed the association between body mass index (BMI) and prostate cancer risk. For every 5-point BMI increase, the risk to develop an aggressive form of prostate cancer is elevated with 9%. In the same time, for every 5-point BMI increase the risk to develop a less aggressive form of prostate cancer diminished with 6%. The study was published this month in the Annals of Oncology.

Body mass index shows the relation between how many kilograms has a person and his/her height (body weight in kilograms divided by the square of his/her height in meters). A normal BMI ranges from 18.5 to 25. For children there is another calculation that implies age and sex. A person under 20 with a BMI between the 85th and 95th percentile is overweight.

Another study showed that obesity multiplied the risk of metastases by 5 and prostate cancer grew 3 times faster in obese patients. The study was presented in 2011 at the American Urological Association annual meeting.

Other research reports the risk of death from prostate cancer is 25% higher for overweight men and to obese men the risk may be double than of normal-weight men.

There are reactions in the medical field: prostate cancer screening is increasing in obese men, according to the Journal of Obesity.

“This is good news. Physicians recognize increased risk factors in their obese patients and are encouraging vigilance when it comes to prostate cancer PSA testing,” said Dr. David Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center.

An obese patient requires a much careful analysis of treatment options, because the common surgical complications can be more frequent and more severe in patients with high BMI. During the surgery, extended surgical time and increased hemorrhage (bleeding) are the main concerns regarding men with obesity.

The age of the patient and his general health combined with the experience and the skills of the surgeon have a great influence on prostate cancer outcomes.

“There’s so much we can’t yet control about our medical path, particularly in the area of cancers, but what we can do is optimize our general wellness. Maintaining a healthier weight, eating better, getting active, those are all places to start… Many health issues can be avoided through wellness, and for those that can’t, well, healthier men are certainly better equipped to withstand the rigors of prostate cancer treatment and recovery, if necessary,” said Dr. David Samadi.

Generally, prostate cancer causes no symptoms in the early stage.

In some cases, may occur frequent urination, nocturia (increased urination at night), difficulty starting and maintaining a steady stream of urine, hematuria (blood in the urine), dysuria (painful urination), difficulty achieving erection or painful ejaculation.

A lot of prostate cancers are indolent and would never progress to a clinically meaningful stage, but there are other prostate cancers potentially lethal.

Prostate cancer screening is performed by two methods: the digital rectal examination (DRE), and the prostate-specific antigen (PSA) blood test.

Prostate test screening is controversial. The United States Preventive Services Task Force (USPSTF) concluded in 2011 that “prostate-specific antigen–based screening results in small or no reduction in prostate cancer–specific mortality and is associated with harms related to subsequent evaluation and treatments, some of which may be unnecessary.”

“Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment. Starting at age 50, (45 if African American or brother or father suffered from condition before age 65) talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you.“

The diagnosis of prostate cancer can be confirm only by a biopsy.

During life time one in six Americans will be diagnosed with prostate cancer, it is estimated. One in three U.S. men are considered obese. Obesity is the second leading risk factor for developing cancer.