Originally published 7/13/2015
If the 2015 picture painted in our original blog below wasn’t very rosy, it hasn’t gotten any better as shown in two more recent studies.
The first, a 2021 review of published mortality statistics on prostate cancer (PCa) patients whose body-mass index (BMI) was known included data from 59 papers involving a total of 280,199 patients.[i] The authors note, “Owing to the large sample size, we were able to undertake powerful analyses, including predefined subgroup analyses, to generate reliable results.” The authors concluded, based on the observational evidence, that obesity increases mortality in PCa patients. Given that modifiable lifestyle factors (diet, exercise) can affect different outcomes, the authors recommend that literature for patients include information on the importance of healthy weight for PCa survival.
The second article, from 2022, underscores that overweight and obese PCa patients have higher risks of recurrence, treatment side effects, earlier cancer progression / metastatic disease, and death from prostate cancer.[ii] The authors present evidence that inflammatory factors and metabolic imbalances are causal factors for poor PCa prognosis, including less robust treatment results. Again, they stress that weight loss strategies can lower PCa death rates.
In short, it’s our 2015 blog all over again.
You’ve probably heard that obesity is considered a U.S. epidemic, from kids through adolescents and adults. It is a major public health concern for middle-aged and older men, who are also at increased risk for prostate cancer (PCa) which is an aging-related disease. According to one report (Zlotta et al., 2013) analyzed autopsy specimens of men who died from other causes than prostate cancer. They wrote, “ In men aged greater than 60 years, PCa was observed in more than 40% of prostates, reaching nearly 60% in men aged greater than 80 years.”[iii] So at the same time that men often start to gain weight, the potential for trouble is building in their prostate glands.
We know that for healthy men diagnosed with PCa, the cancer is not what they eventually die of. According to the American Cancer Society, for all stages of the disease,
- The relative 5-year survival rate is almost 100%
- The relative 10-year survival rate is 99%
- The 15-year relative survival rate is 94%.
However, for obese men, the prostate-cancer specific survival rates are worse. A new study from Italy should give overweight PCa patients good reason to change their dietary and exercise habits. Cantarutti et al. (2015) analyzed the clinical histories and causes of death of 3161 PCa patients. After 11 years of follow-up, 1,161 of the men had died (37%); for 690 of them (59%) the cause of death was prostate cancer. In order to establish the connection between obesity and PCa as the cause of death, the authors correlated body mass index (BMI) with the PCa-specific deaths. They found that those with the highest BMI (greater than or equal to 27.5 kg/m, which equates to obesity) had a significant increased risk of dying from prostate cancer, but also a greater mortality risk form any cause compared to those with normal BMI (22.5 – 25 kb/m).
It’s not unusual for men at mid-life to begin to put on extra weight. Often, their eating habits remain the same as when they were younger but they tend to work out less and lead more sedentary lives. Yet this is also when they are entering a period of increasing prostate cancer risk—and certainly greater chance of benign prostatic hyperplasia which may have some connection with developing PCa. (See my blog at https://sperlingprostatecenter.com/bph-and-prostate-cancer-is-there-a-connection/ for more information.)
We all know the “right” things to do to stay healthy, but knowing does not always mean choosing. I hope that by providing scientific evidence of the connection between high BMI and prostate cancer mortality, I am able to motivate you to get past rationalizations and excuses that might be holding you back. Don’t wait. Start now to develop healthy diet and exercise habits that will lower your weight and add to your quality of life—and of course, your lifespan. As Smokey the Bear would say, “The life you save may be your own.”
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
[i] Rivera-Izquierdo M, Pérez de Rojas J, Martínez-Ruiz V, Pérez-Gómez B et al. Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients. Cancers (Basel). 2021 Aug 19;13(16):4169.
[ii] Wilson RL, Taaffe DR, Newton RU, Hart NH, Lyons-Wall P, Galvão DA. Obesity and prostate cancer: A narrative review. Crit Rev Oncol Hematol. 2022 Jan;169:103543.
[iii] a href=”http://www.ncbi.nlm.nih.gov/pubmed/?term=Zlotta%20AR%5BAuthor%5D&cauthor=true&cauthor_uid=23847245″>Zlotta AR1, Egawa S, Pushkar D et al. Prevalence of prostate cancer on autopsy: cross-sectional study on unscreened Caucasian and Asian men. J Natl Cancer Inst. 2013 Jul 17;105(14):1050-8.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
