Obesity and Prostate Cancer Risk

The link between obesity and diseases such as diabetes and heart disease has been well established. While not as well known, there is, unfortunately, a link between obesity and prostate cancer. If you are not of a healthy weight and are concerned about your prostate cancer risk, it may be beneficial for you to understand the relationship between the two. This may provide you with more information to take the necessary steps moving forward.

Numerous studies have documented the correlation between obesity and various cancers, including prostate cancer. It is consistently demonstrated across multiple investigations that obesity serves as a risk factor for the onset of advanced or aggressive prostate cancer (with odds ratios ranging from 1.10 to 2.47) and the progression to high-grade disease (with odds ratios ranging from 1.49 to 2.56). It appears that obesity is not associated with risk of getting prostate cancer in general, but it is associated with a higher risk of getting more aggressive prostate cancer, which has a higher likelihood of spreading and causing death.

There are several proposed mechanisms by which obesity may influence prostate cancer risk:

• Increased insulin and IGF-1 levels.

Prostate cancer in humans often expresses the insulin receptor, which suggests that insulin may promote prostate cancer growth. Insulin also has anabolic, anti-apoptotic and mitogenic effects that may affect the growth of prostate cancer cells. Since obesity tends to be associated with hyperinsulinemia, it is thus linked to prostate cancer risk.

Obesity and hyperinsulinemia are also associated with increased levels of IGF-1 that are bioavailable to cells, which has a pathogenic role in many cancers.

• Altered sex hormone levels.

Altered sex hormone levels such as decreased serum testosterone and peripheral aromatization of androgens are two known impacts that obesity has on one’s sex hormone levels. It is generally known that male sex hormone levels, or androgens, might promote the development of well-differentiated prostate cancers, while having a protective effect against poorly differentiated prostate cancers. As obesity is typically closely linked to low androgen levels, obese people have a higher risk of developing poorly differentiated and androgen dependent prostate cancer.

• Altered adipokine signaling caused by inflammation.

Obesity has been found to contribute to chronic inflammation, which has impacts on adipokine signaling such as higher levels of leptin and lower levels of adiponectin, and have been associated with prostate cancer, though findings have been somewhat controversial.

The levels of leptin, a hormone derived from adipocytes, are elevated in central obesity and promote tumor growth in human prostate cancer cell lines by stimulating angiogenesis and increasing sympathetic nervous system activity.

In contrast, adiponectin has predominantly anti-tumor effects, inhibiting cancer cell growth and metastasis, blocking dihydrotestosterone, and reducing inflammation by impeding the activity of mature phagocytic macrophages. However, central obesity is associated with reduced serum levels of adiponectin.

These combined mechanisms contribute to heightened proliferation, reduced apoptosis, and the transition away from androgen dependence to independence. It is important to note that the mechanisms of prostate cancer development and progression are complex and multi-faceted. A lot of what influences prostate cancer risk are still unknown or unconfirmed.

Fortunately, obesity is a modifiable risk factor and evidence seems to point to the benefits of weight loss on prostate cancer risk. In fact, the World Cancer Research Fund and the World Health Organization have identified obesity as a crucial factor to be managed in efforts to reduce advanced prostate cancer risk and improve prognosis. While there are currently no clinical recommendations and guidelines on weight loss and prostate cancer risk specifically, it is generally recommended to keep a healthy weight to minimize prostate cancer risk.

Learn more: Can Exercise Reduce Prostate Cancer Risk?

It's important to note that while obesity is considered a risk factor, it is just one of many factors that can influence a person's likelihood of developing prostate cancer. Other factors such as age, family history, and genetics also play a role. Maintaining a healthy weight with a balanced diet and regular physical exercise is generally recommended for overall health and may also help reduce the risk of prostate cancer.