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JU INSIGHT Impact of Weight Management on Obesity-Driven Biomarkers of Prostate Cancer Progression
By: Misty D. Bechtel, CCRP, University of Kansas Medical Center, Kansas City; Carrie Michel, MS, RD, LD, CSO, University of Kansas Medical Center, Kansas City; Pugazhendhi Srinivasan, PhD, University of Kansas Medical Center, Kansas City; Prabhakar Chalise, PhD, University of Kansas Medical Center, Kansas City; William P. Parker, MD, University of Kansas Medical Center, Kansas City; Moben Mirza, MD, University of Kansas Medical Center, Kansas City; Brantley Thrasher, MD, University of Kansas Medical Center, Kansas City; Heather D. Gibbs, PhD, RD, University of Kansas Medical Center, Kansas City; John DiGiovanni, PhD, College of Pharmacy, The University of Texas at Austin, Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin; Jill Hamilton-Reeves, PhD, RD, LD, CSO, University of Kansas Medical Center, Kansas City | Posted on: 19 Apr 2024
Bechtel MD, Michel C, Srinivasan P, et al. Impact of weight management on obesity-driven biomarkers of prostate cancer progression. J Urol. 2024;211(4):552-562.
Study Need and Importance
Obesity and prostate cancer commonly occur together in aged men. Unfortunately, obese men and men who gain weight around the time of radical prostatectomy are at a higher risk of recurrence and death from prostate cancer, as well as having a higher risk of cardiovascular disease and death due to any cause. The window between diagnosis and surgery can be the optimal time to promote weight loss to improve the surgical benefits since it is safe, and diagnosed patients are often motivated to improve their health and quality of life. Weight loss lowers the risk of other hormone-driven cancers and cardiovascular disease risk factors. Our trial tested whether weight reduction counteracts obesity-driven prostate cancer biomarkers.
What We Found
The Figure shows the net percent weight loss of all participants. Our calorie restriction plan, coaching healthy nutrition practices, and exercise led to 5.5% weight loss from baseline to radical prostatectomy and a net loss of 11% initial body weight 6 months after surgery. The intervention group improved diet quality, achieved fat loss, enhanced general and emotional health, and improved prostate cancer biomarkers that are also associated with weight/fat loss (insulin, leptin:adiponectin ratio, cholesterol).
Limitations
The clinical trial had a small sample size. The comparison of prostate tissue before and after the intervention can be challenging with the multifocal nature of prostate cancer. The men in the intervention group had a lower rate of high-grade and locally advanced disease than the control group, which could impact the perception of health or inflammation markers.
Interpretation for Patient Care
Clinically significant weight loss is achievable and sustainable in this setting. Many prostate cancer and cardiovascular disease biomarkers favorably improved with the intervention, which may reduce the risk of cardiovascular disease and, potentially, recurrence.
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