Mortality, body mass index, and Gleason score: the relationship


New data appear to suggest that you really don’t want to be diagnosed with high-risk prostate cancer if you are significantly over-weight or obese.

Haque et al. looked at data from three large US-based health plans (including the Kaiser Permanente data sets from northern and southern California) to explore whether there was a clear association between increased body mass index (BMI) at time of prostate cancer diagnosis and subsequent prostate cancer-specific mortality.

Their data are based on a population-based case-control study which looked at 751 men with prostate cancer who underwent a standard form of first-line therapy.

Here is what they found:

  • The “cases” were 323 men who died of prostate cancer after having had a radical prostatectomy.
  • The matched “controls” were 428 men who had undergone a radical prostatectomy but had not died of their prostate cancer.
  • The study subjects were grouped according to their BMIs.
    • The “healthy” group had a BMI of 18.5 to 24.9.
    • The “overweight” group had a BMI of 25.0 to 29.9.
    • The “obese” group had a BMI of ≥ 30.
  • Just under 43 percent of the participants had a BMI ≥ 25 at diagnosis.
  • A relatively larger percentage of the cases (30 percent) were obese as compared to the controls (22 percent).
  • Compared to men with prostate cancer in the healthy group, men in the obese group were > 50 percent more likely to die of their prostate cancer (adjusted odds ratio [aOR] = 1.50).
  • After stratifying the patients by Gleason score, the odds of mortality generally rose with increasing BMI.
  • The strongest effect was observed in men with a Gleason score of ≥ 8 (aOR = 2.37).
  • These associations persisted after adjustments for PSA level at diagnosis and other tumor characteristics.

In other words, at least in this study, if you are over-weight or obese and you are diagnosed with prostate cancer with a Gleason score of ≥ 8, you are more than twice as likely to die of your cancer as is an otherwise comparable man with a healthy BMI.

One Response

  1. Also relevant to that is the high levels of estradiol in very overweight or obese men, and the correspondingly low levels of testosterone!

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