Obese blacks and whites risk prostate cancer recurrence

Men who have an undergone prostate cancer treatment and are obese are found to be at risk for recurrence of the disease, despite race. Past studies have suggested that obese blacks are more at risk for recurring prostate cancer than are whites. The new analysis shows that obesity increases the risk of recurring prostate cancer in both groups.

Stephen Freedland, M.D., an associate professor of urology and pathology in the Duke Prostate Center authored the new study published in the journal Cancer. The researchers found that obesity increases the chances of recurring prostate cancer by studying records of 1,415 men enrolled in the Shared Equal Access Regional Cancer Hospital (SEARCH) database who had radical prostatectomy for prostate cancer. Forty-seven percent were black.

The researchers examined body mass index, finding that unlike other studies, there was no difference between blacks and whites who were obese and the aggressiveness of prostate cancer.

According to lead study author, Jayakrishnan Jayachandran, M.D. a urologic oncology fellow at Duke, “We found that higher BMI was associated with significantly increased risk of cancer recurrence for both blacks and whites. 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.” Almost one third of the men in the data base were obese.

Obesity is associated with hormonal imbalances, perhaps fueling prostate cancer and making it more likely to recur. Insulin imbalances associated with obesity may also play a role. Men who are obese have less testosterone and higher estrogen levels. The researchers say that obesity increases the chances of aggressive prostate cancer that is more likely to recur possibly from altered hormone levels. The chance that prostate cancer will recur in obese men is equal, regardless of race.

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