In 2012, prostate cancer was the second-most frequent non-skin cancer in the United States — 105 new cases per 100,000 population. Many times, prostate cancer is not life-threatening — it is indolent, not progressing quickly and not metastasizing to other parts of the body. It's said, especially for older men, that you can die with prostate cancer, but from a different cause. But the disease can be aggressive — both progressing quickly and spreading to bone and brain as well as other tissue — and this type can well be fatal. Although it is not rare, other than family history and age, the risk factors for prostate cancer are not well understood.
But a recent report of data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study suggests that obesity — especially central obesity — is linked to the risk of developing the more aggressive type of prostate cancer. The study followed nearly 142,000 men for an average of 14 years. They were from eight European countries — Italy, Spain, the UK, the Netherlands, Greece, Germany, Denmark and Sweden, and initially were an average of 52 years old. Dr Aurora Perez-Cornago, from the University of Oxford, UK, and colleagues performed this analysis, which was presented at this year's European Obesity Summit in Gothenburg, Sweden.
After 14 years, there were about 7,000 cases of prostate cancer diagnosed, and 934 of them were fatal. The researchers most closely examined those individuals whose tumors were high stage (they were large and had metastasized out of the prostate) and high grade (the tumor cells were very abnormal).
While Body Mass Index (BMI, kgm/m2) alone is not the best indicator of adiposity, a high BMI coupled with a large waist circumference suggests that the individual likely has a high degree of fat deposited in the truncal or central region. This type of obesity is known to be linked with a variety of ailments such as Type 2 diabetes, high blood pressure and heart disease. It is a reflection of not just fat that sits under the skin (subcutaneous fat), but of fat that surrounds organs (visceral fat) — the toxic component of central adiposity.
In the current study, the researchers found that there was a 14 percent greater risk of fatal prostate cancer for every 5 BMI unit increase, and an 18 percent increased risk for every 10 centimeter increase in waist circumference.
According to the authors, their analysis suggests an important association between greater adiposity and a greater risk of more aggressive prostate cancer. It's important to emphasize that such an association doesn't have to mean that increased adiposity causes this type of prostate cancer, but it does suggest that this may be the case. Follow-up with other studies are needed to confirm this association. In the meantime, there's yet another reason to attain and maintain a healthy body size.