Weight Change and Prostate Cancer

Obese men have a higher risk of dying from prostate cancer than men of normal weight, according to new findings from the NIH-AARP Diet and Health Study. Men who reported weight gain after age 18 were also found to be at increased risk of dying from prostate cancer. These findings did not change when age, family history of prostate cancer, race, or past screening history were accounted for. The most likely explanation underlying the observed association is that heavier men have hormonal alterations that adversely affect prostate cancer progression leading to death.


A total of 287,760 male study participants were included in this analysis. Men were between 50 and 71 years of age at the start of the study in 1995-1996, at which time they filled out questionnaires that asked about height, weight, and other factors, as well as cancer screening practices. The authors of this study looked at body mass index (BMI), which was calculated from height and weight. They also examined weight change from age 18 years to baseline (1995-1996). Approximately 29 percent of men were classified as normal weight (BMI<25 kg/m2), 50 percent as over- weight (BMI 25-29.9 kg/ml), and 21 percent as obese (BMI>30 kg/M2) . During five years of follow-up, 9,986 cases of prostate cancer were identified. During six years of follow-up, 173 prostate cancer deaths occurred.

This study had several strengths, including the large number of men with prostate cancer, a wide range of reported weights, and the ability to determine if any other factors affected the association between BMI and prostate cancer risk. These study results add to the growing evidence that obesity increases the risk of fatal prostate cancer. Also, this is the first prospective study to identify increasing weight after age 18 as a risk factor for prostate cancer death. The authors conclude that maintaining a healthy weight through diet and exercise is not only pertinent to reducing the risk of prostate cancer death, but is also beneficial for many other health conditions.

These study results supplement other studies showing similar results about the relationship of obesity to prostate cancer occurrence and death, suggesting another reason for public concern about obesity found in the U.S. and around the world.

By Wright, Chang Schatzkin et a!.
Cancer
February 15,2007

PROSTATE CANCER PATIENT SUPPORT
1 800 80 Us TOO


Radiation Treatment After Radical Prostatectomy Reduces Risk of "Biochemical Progression"

Adding radiation treatment to radical prostatectomy may reduce the risk of cancer progression among men with locally advanced prostate cancer.

Locally advanced disease is cancer that has spread beyond the prostate capsule or has other highrisk features. It is associated with an increased risk of cancer progression. Prostate cancer specialists use a rising PSA level after surgery to designate "biochemical" cancer progression. In this study, researchers randomly assigned 503 men who had undergone radical prostatectomy to no immediate additional treatment and 502 men to immediate treatment with conventional external beam radiation. The study participants were monitored for an average of 5 years.

The researchers found that men who underwent radiation treatment after surgery were less likely to experience a biochemical recurrence. Among men in the irradiated group, 74% were free of biochemical progression during the followup period, compared to 52.6% of those in the no-additional-treatment group. As expected the irradiated men experienced more late side effects from treatment than the surgery-only patients. But severe side effects were rare,

LANCET
Volume 366, Page 572
August 13-19, 2005


No Disadvantage Seen with Intermittent Androgen Suppression for Advanced Prostate Cancer

Intermittent androgen suppression (lAS) therapy for prostate cancer does not diminish survival nor hasten tumor progression compared with continuous therapy, and it may confer a small advantage in quality of life, Kurt Miller, MD, reported at the 2007 annual meeting of the American Urological Association.

Many urologists already use intermittent therapy in the hopes of sparing patients the adverse effects and qualityof-life reductions associated with continuous androgen suppression.

These findings will help practicing urologists feel more comfortable with using lAS, and suggest that intermittent therapy is a safe and viable option for patients with stage Dl or D2 prostate cancer.

Is intermittent blockade now the standard of care? No, but we can offer it safely to patients with advanced prostate cancer.

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