Sperling Prostate Center

Once Again Obesity is Linked with Aggressive Prostate Cancer

UPDATE: 11/7/2023
Originally published 12/26/2016

Fat cells are essentially containers that store energy. However, they also play an important health role by signaling bioactive factors that influence the endocrine and immune systems, and impact the behavior of other kinds of cells. Here is a simplified explanation of how an overabundance of fat can turn insignificant prostate cancer into a life-threatening disease.

As a man gains weight, his body makes more and bigger fat cells (adipocytes) and fat stem cells (adipose stromal cells or ASCs) that become adipocytes.

One site for fat deposits is the periprostatic tissue adjacent to and surrounding the prostate gland.

Imagine your prostate gland wrapped in fat. If a man develops prostate cancer, the adipocytes and ASCs spell trouble. The bioactive factors of the ASCs act as “important drivers of obesity-associate cancer progression.”[i]

Progression means the cancer cells become more aggressive, more dangerous. The factors also support the manufacture of new veins to carry oxygen and nutrients to the tumor, a process called neovascularization. Meanwhile, the prostate cancer cells are using the adipocyte’s stored energy to fuel themselves.

As the tumor grows and evolves, it both blocks and hijacks some immune system mechanisms, thus becoming more able to metastasize (spread) and resist therapies like androgen deprivation (chemical castration) and chemotherapies.

These processes help to explain why overweight or obese prostate cancer patients are frequently the victims of more sinister prostate cancer than their normal-weight counterparts.

Read the original blog below for an example of a study that demonstrated the link between obesity and dangerous prostate cancer.


I have posted numerous blogs on the risk of aggressive prostate cancer (PCa) for men who are overweight. Once again, research bears this out. A new Canadian study involved 51 patients scheduled for a prostate biopsy who were first evaluated for factors related to body composition and metabolism.[ii] Once the biopsy results were in, the cases were evaluated for the presence or absence of PCa, and Gleason score if cancer was found.

The researchers found that patients who were diagnosed with Gleason > 4+3 had the following:

  1. Significantly larger waist measurements
  2. Significantly larger hip measurements
  3. Higher body mass index (BMI
  4. There were no differences in fasting glucose (blood sugar) but there were significantly higher C-peptide concentrations for the same group, “suggesting greater insulin secretion” which may indicate a precursor for diabetes. NOTE: Obesity and diabetes are closely associated.

Also, patients who were not diagnosed with cancer had greater skeletal muscle mass.

What does all this add up to? It means that a fitness lifestyle (good nutrition, regular vigorous exercise, stress management – yes, stress hormones contribute to poor metabolism and obesity – and supplements) reduces many risks, including prostate cancer aggression. There is additional research evidence that a concerted fitness lifestyle actually promotes change at the genetic level whereby genes that promote tumor activity are “switched off” and genes that inhibit tumor activity are “switched on.”

There are so many benefits to achieving and maintain proper weight and normal BMI. Adding prostate cancer prevention to the list can only boost a man’s motivation even further.

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] Saha A, Kolonin MG, DiGiovanni J. Obesity and prostate cancer – microenvironmental roles of adipose tissue. Nat Rev Urol. 2023 Oct;20(10):579-596. doi: 10.1038/s41585-023-00764-9.
[ii] Di Sebastiano KM, Pinthus JH, Duivenvoorden WC, Patterson L, Dubin JA, Mourtzakis M. Elevated C-Peptides, Abdominal Obesity, and Abnormal Adipokine Profile are Associated With Higher Gleason Scores in Prostate Cancer. Prostate. 2016 Oct 4 [Epub ahead of print]. doi: 10.1002/pros.23262. PMID: 27699825


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.

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