Obese men fare well after prostate cancer surgery

Although obese men tend to have more aggressive prostate cancer going into surgery, they do just as well as thinner men in the years afterward, a study suggests.

The findings, published in the journal Cancer, suggest that obese men need not fear that their weight will add to their risk of cancer recurrence or death.

“I think this is a reassuring study for obese men,” lead study author Dr. Sameer A. Siddiqui told Reuters Health. “Even with worse cancers, their outcomes were the same.”

The role of obesity in prostate cancer—both its development and its response to therapy—has not been clear. Some studies, but not all, have found that compared with normal-weight men, obese men may be at greater risk of tumor recurrence after having surgery to remove the prostate gland.

To investigate, Siddiqui and his colleagues at the Mayo Clinic in Rochester, Minnesota, followed more than 5,300 men who’d undergone radical prostatectomy at their center in the 1990s. Radical prostatectomy removes the whole prostate gland and nearby lymph nodes.

The researchers found that while obese men were more likely to have relatively aggressive tumors, their risk of death or cancer recurrence in the decade following surgery was comparable to that of normal-weight men.

Siddiqui called this a “testament to the durability of radical prostatectomy.”

As for why obese men tend to go into surgery in somewhat worse shape, experts have speculated that there could be basic biological differences in the prostate tumors of overweight and normal-weight men.

However, Siddiqui and his colleagues believe that it may be more difficult to screen for and diagnose prostate cancer in obese men. One way to assess men for the disease is with a digital rectal exam, and this was more likely to underestimate the stage of tumors in obese men compared with thinner men in the current study.

Blood tests that look for high levels of prostate-specific antigen (PSA) might also be less sensitive in obese men, according to Siddiqui, because they tend to have generally lower PSA levels than normal-weight men do.

But the bottom line, Siddiqui said, is that obese men should not be treated any differently. Even if they have somewhat more aggressive tumors, he said, these findings suggest they fare well in the long run.

SOURCE: Cancer, August 1, 2006.

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