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Obesity increases risk of prostate cancer recurrence for both blacks and whites
August 14, 2009DURHAM, N.C. - A new look at a large database of prostate cancer patients shows that obesity plays no favorites when it comes to increasing the risk of recurrence after surgery: Being way overweight is equally bad for blacks and whites, say researchers at Duke University Medical Center.
Studies have shown that obesity is linked to generally worse outcomes in many cancers, including prostate cancer. Because blacks are more likely than whites to develop and die from prostate cancer - and because there is a higher prevalence of obesity among black men with prostate cancer, compared to whites - some studies have suggested that obesity might be a more ominous risk factor for blacks than whites.
"Not so," says Stephen Freedland, M.D., an associate professor of urology and pathology in the Duke Prostate Center and the senior author of the study appearing in the journal Cancer. "Obesity leads to worse cancer in both groups."
Freedland and Jayakrishnan Jayachandran, M.D. a urologic oncology fellow at Duke and the lead author of the paper, examined the records of 1,415 men enrolled in the Shared Equal Access Regional Cancer Hospital (SEARCH) database who had undergone a radical prostatectomy. Black men comprised almost half (47 percent) of the sample.
After adjusting for various preoperative characteristics, researchers analyzed the relationship between body mass index (BMI) and the aggressiveness of the cancer, as measured by the risk of recurrence. In contrast to other studies, investigators found no association between race and obesity.
Almost a third of the men were obese, regardless of race. "We found that higher BMI was associated with significantly increased risk of cancer recurrence for both blacks and whites," said Jayachandran. "Though prior SEARCH-based studies from our group found that obesity was associated with a higher risk of disease progression as measured by a rising PSA after surgery, it now appears that being obese just means a poorer prognosis, period, regardless of race."
As for why that might be, Jayachandran says he's not sure, but he says it may have something to do with altered hormone levels.
"Obesity is associated with more estrogen and less testosterone, and it may be that lower testosterone promotes more aggressive tumors as recent studies have suggested." In addition, Jayachandran says alteration in the production of other hormones, like insulin, insulin-like growth factor or leptin, which occur in obese men, may also be involved in the development of more aggressive tumors. "This is something we simply do not understand, but we are actively studying all of these factors."
Duke University Medical Center
Freedland and Jayakrishnan Jayachandran, M.D. a urologic oncology fellow at Duke and the lead author of the paper, examined the records of 1,415 men enrolled in the Shared Equal Access Regional Cancer Hospital (SEARCH) database who had undergone a radical prostatectomy. Black men comprised almost half (47 percent) of the sample.
After adjusting for various preoperative characteristics, researchers analyzed the relationship between body mass index (BMI) and the aggressiveness of the cancer, as measured by the risk of recurrence. In contrast to other studies, investigators found no association between race and obesity.
Almost a third of the men were obese, regardless of race. "We found that higher BMI was associated with significantly increased risk of cancer recurrence for both blacks and whites," said Jayachandran. "Though prior SEARCH-based studies from our group found that obesity was associated with a higher risk of disease progression as measured by a rising PSA after surgery, it now appears that being obese just means a poorer prognosis, period, regardless of race."
As for why that might be, Jayachandran says he's not sure, but he says it may have something to do with altered hormone levels.
"Obesity is associated with more estrogen and less testosterone, and it may be that lower testosterone promotes more aggressive tumors as recent studies have suggested." In addition, Jayachandran says alteration in the production of other hormones, like insulin, insulin-like growth factor or leptin, which occur in obese men, may also be involved in the development of more aggressive tumors. "This is something we simply do not understand, but we are actively studying all of these factors."
Duke University Medical Center
Obesity Current Events and Obesity News RSSPatient's weight not linked to success of fibroid surgery
Obese patients are no more likely to have post-operative complications than those of average weight when undergoing robotic surgery to remove uterine fibroids, according to a study at Henry Ford Hospital.
Scripps research scientists find new link between insulin and core body temperature
A team led by scientists at The Scripps Research Institute have discovered a direct link between insulin-a hormone long associated with metabolism and metabolic disorders such as diabetes-and core body temperature.
Night Beat, Overtime and a Disrupted Sleep Pattern Can Harm Officers' Health
A police officer who works the night shift, typically from 8 p.m. to 4 a.m., already is at a disadvantage when it comes to getting a good "night's" sleep.
Fat collections linked to decreased heart function
Researchers from Boston University School of Medicine (BUSM) have shown that fat collection in different body locations, such as around the heart and the aorta and within the liver, are associated with certain decreased heart functions.
Teens' mental health affects how long they stay in school, new study shows
Queen's University researcher Steven Lehrer has won a prestigious international award in recognition of his contributions to health economics.
Playing sport up to the end of pregnancy is healthy for the baby and the mother
Contrary to more conservative customs, exercising up to the end of pregnancy has no harmful effect on the weight or size of the foetus.
Harvard nutrition expert offers family physician group no-cost alternative to funding from Coca-Cola
Leading Harvard School of Public Health (HSPH) nutrition and health researcher Walter Willett, M.D., Dr. P.H., has written a letter to the President-elect of the American Academy of Family Physicians (AAFP) offering an alternative to the organization's decision, announced in October, to accept a six-figure grant from the Coca-Cola Company to develop web content on beverages and maintaining a healthy lifestyle.
New paper describes connections between Circadian and metabolic systems
A paper by University of Notre Dame biologist Giles Duffield and a team of researchers offers new insights into a gene that plays a key role in modulating the body's Circadian system and may also simultaneously modulate its metabolic system.
Aileron collaborates study in Nature: Stapled peptides inhibit Notch1 transcription factor
This research validates the potential for Stapled Peptides to modulate key intracellular biological targets, such as transcription factors, that have not been addressable with current small molecule or biologic drug modalities.
Worksite wellness programs may reduce employee absenteeism
Emory University Rollins School of Public Health researchers will present Nov. 11 on a range of topics at the American Public Health Association's annual meeting in Philadelphia, including a study that found reduced absenteeism among employees participating in a large-scale worksite wellness program.
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