After a careful review of the published literature, researchers at Duke University have now provided solid evidence for what many studies have already suggested; that obesity is linked to worse outcomes in patients with prostate cancer.
The data shows that obese men are at increased risk for high-grade, advanced disease, and higher levels of cancer recurrence. While the exact reason for this finding is unclear, it may be due to several factors. Detecting prostate cancer in the first place is more difficult in obese patients since they can have PSA levels that are falsely low.
Furthermore, obese patients have larger prostates that can lead to insufficient biopsies that don't reveal the true extent or grade of the cancer. Additionally, obesity leads to higher levels of estrogen and lower levels of testosterone in the body, which also may prove to be related to these findings.
The medical community is learning more and more every day about how obesity can cause widespread problems in various parts of the body. So let's quickly review the harmful cycle that can start when we don't give our weight the serious attention it deserves.
When you're overweight, and specifically if you have a high level of belly fat (also called visceral fat, as it surrounds the organs or "viscera" inside the belly) your "bad" cholesterol (LDL) will increase while the "good" cholesterol (HDL) will decrease.
Obese patients are also at an increased risk of developing type 2 diabetes. In this disease, insulin, which normally helps lower your blood sugar, cannot communicate effectively with the liver, leading to high levels of sugar in the blood. While diabetes can damage the kidney over the long-term, obesity affects the kidney directly as well, leading to increased reabsorption of sodium into the blood. This high level of sodium causes high blood pressure. The combination of diabetes, high cholesterol, and high blood pressure is known as "metabolic syndrome," and having this syndrome puts you at increased risk for stroke and heart attack.
This dangerous connection between obesity, diabetes, blood pressure, stroke and heart disease is what we need to prevent. And now that obesity has been linked to more aggressive forms of prostate cancer, every man should have all the incentive he needs to lose weight.
In fact, the obesity cycle presents all of us with a unique opportunity. If we get back to the gym, stay active and eat smaller portions, we can keep many crucial parts of our body healthy at the same time. It's as close to a universal cure as you're probably going to find these days.
David B. Samadi, MD is the Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine in New York City. As a board-certified urologist and an oncologist specializing in the diagnosis and treatment of urologic diseases, kidney cancer, bladder cancer, and prostate cancer, he also specializes in many advanced minimally invasive treatments for prostate cancer, including laparoscopic radical prostatectomy and laparoscopic robotic radical prostatectomy. His Web site, Robotic Oncology, has been translated into six different languages and is one of the most popular urology sites on the Internet. Find Dr. Samadi on Facebook. Follow Dr. Samadi on Twitter @drdavidsamadi.