Prostate news article, August 2004
| IMPACT OF OBESITY
ON PROSTATE CANCER AND OUTCOME FROM RADICAL PROSTATECTOMY
Mr Majid Shabbir BSc(Hons), MBBS (Hons), MRCS(Eng) Urology Research Fellow, Royal Free Hospital, London |
Obesity is a major health problem. Approximately 17% of men in the U.K. are obese. The 'high-fat, fast food diet' of the western world has seen a rapid increase in the number of cases in the last two decades.
Obesity is known to be associated with a number of health problems including diabetes, heart disease, high blood pressure, and stroke. It is also known to be linked to higher rates of certain types of cancer including cancer of the colon and rectum. Until recently, little has been known about the relationship between prostate cancer and obesity. Epidemiological studies have previously suggested that obesity may be protective for developing prostate cancer, yet when the disease does develop it appears to be more aggressive.
In this month's Journal of Urology, Freedland et al (J Urol 172:520-524, 2004) looked at PSA recurrence in men with organ confined prostate cancer treated with radical prostatectomy. Previous studies by the same group had shown a higher PSA recurrence rate in obese men, although this was thought to be related to a higher rate of positive surgical margins in these patients as a consequence of greater technical difficulty during surgery.
In their current study, Freedland et al looked specifically at patients with clear surgical margins, to assess if obesity itself had a specific effect on long-term outcome. They found that moderately and severely obese patients had both higher-grade tumours and a 4-fold greater risk of PSA failure compared to normal weight and overweight patients.
In conclusion this study found that obesity is associated with a more aggressive form of prostate cancer and this further highlights the importance of tackling obesity in improving men's health.