Metabolic syndrome and risk for prostate cancer-specific mortality


According to an article due to be published on line today in Cancer,  a group of clinical characteristics commonly referred to as “metabolic syndrome” are strongly associated with an increased risk for prostate cancer-specific mortality among men diagnosed with prostate cancer, but are not associated with an increased risk for the initial diagnosis.

The article by Häggström et al. is based on  a careful analysis of data from nearly 300,000 male, Swedish patients enrolled in the Metabolic Syndrome and Cancer Project.

The study participants were followed over a period of 12 years, with the following basic outcomes (regarding prostate cancer):

  • The total number of enrollees was 289,866.
  • During the 12-year follow-up
    • 6,673 patients (2.3 percent) were diagnosed with prostate cancer
    • 961 patients (0.3 percent) died of prostate cancer
  • Among the men diagnosed with prostate cancer,
    • Those with the highest levels of body mass index had a 36 percent increased risk for prostate cancer-specific mortality.
    • Those with the highest blood pressure levels had a 62 percent increased risk for prostate cancer-specific mortality.
    • Those with the highest composite metabolic syndrome scores were also at increased risk for prostate cancer-specific mortality.

Metabolic syndrome is a series of characteristics (including high blood pressure, high blood sugar levels, high blood lipid levels, and a high body mass index)  that are closely associated with risk for cardiovascular disease and diabetes. However, this study by Häggström and her colleagues appears to confirm other data suggesting that metabolic syndrome increases a man’s likelihood of dying from prostate cancer once he has been diagnosed. It is also easy to see why, if this is the case, that prostate cancer patients receiving treatment with statins might improve both their overall and their prostate cancer-specific survival compared to statin non-users.

To quote the simple statement made by the senior author of this paper, Dr. Per Stattin: “These observations suggest that cardiovascular risk factors such as [excess weight] and hypertension are involved in stimulating the progression of prostate cancer.”

The implication is simple from a public health perspective: any man diagnosed with prostate cancer should make appropriate efforts to lower his blood pressure, his blood sugar levels, his blood lipid levels, and his body mass index into the normal range to lower his risk for prostate cancer-specific mortality. This can be done through a combination of activities that certainly include weight loss, improved diet management, regular exercise, and (in appropriate patients) medication to lower blood glucose and elevated cholesterol and lipid levels.

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