What is the role of obesity in the etiology of prostate cancer?

Updated: Oct 11, 2019
  • Author: Mark A Moyad, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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Obesity is one of the strongest dietary/lifestyle factors associated with prostate cancer. Numerous studies have shown that obese men have a greater risk of developing more aggressive prostate cancer, experiencing disease recurrence despite surgery or radiation therapy, and dying of prostate cancer. [16] For example, in the Health Professionals Follow-up Study (HPFS), long-term weight gain after a diagnosis of localized prostate cancer was associated with an increased risk of lethal prostate cancer in non-smokers. [17]  

Another issue that needs more attention is the correlation between obesity and prostate size or volume. [18] Since weight gain can increase prostate size, it can also reduce the ability of standard biopsies to detect cancer at an earlier stage. Also, with increasing prostate size comes increased secretion of prostate-specific antigen (PSA) from non-cancerous prostate tissue, thus providing a more potentially confusing picture for the clinician and patient. If preventing weight gain could reduce prostate enlargement in some men, that alone could provide substantial clinical benefits.

Some of the best data to support an ideal weight loss diet also can be derived from cardiovascular medicine research, such as the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) study, which was one of the longest (2-years) randomized trials. [19, 20, 21] The results of this and other studies suggest that the “end justifying the means” philosophy appears to be the most beneficial. In other words, as long as an individual can maintain reduced caloric consumption over the long term and weight loss actually occurs, the cardiovascular benefits appear to be similar regardless of the type of diet or macronutrient distribution involved.

Again, adherence is key. Whether a reduced-calorie, low-fat, higher-fat, moderate-protein, or higher-protein approach is selected should be based on individual preference, knowing that long-term significant weight loss (the end result) substantiates the method chosen (the means).

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