Obesity May Affect Prostate Cancer Test
Researchers Debate How A Big Man's Blood Volume Affects The Interpretation Of PSA Scores
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(AP)
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The PSA test detects PSA - prostate-specific antigen - in the blood. Only prostate cells give off PSA. PSA levels can rise as prostate tumors grow.
Earlier studies showed that obese men have slightly lower PSA concentrations than lean men do. It's not clear why this is so. New findings from Duke University researcher Stephen J. Freedland,MD, and colleagues now suggest an answer.
"Being a big guy, you have enormous blood volume, so PSA is diluted," Freedland tells WebMD.
"Obese men having these lower PSA values due to the dilution factor means we are going to miss some of them early on."
The researchers reviewed medical records from some 14,000 men with prostate cancer who had their prostate glands removed. Based on the men's body mass index, and adjusting for differences in the men's clinical conditions and prostate pathology, the researchers used pre-operative PSA test values to calculate the actual amount of PSA in the men's blood.
They found that obese men had lower PSA values than did non-obese men even though they had equal or even higher amounts of PSA in their blood.
"What this suggests is if we use the same PSA threshold for obese and normal-weight men, we may be missing some cancers," Freedland says. "For example, a PSA score of 4.1 in an obese man would be diluted down to a 3.3."
"Alan R. Kristal, DrPH, one of the researchers investigating the link between obesity and prostate cancer, strongly disagrees with Freedland's calculation. Kristal is associate head of the cancer prevention program at Seattle's Fred Hutchinson Cancer Research Center.
What this suggests is if we use the same PSA threshold for obese and normal-weight men, we may be missing some cancers.
Duke University researcher Stephen J. Freedland,MDIt's an important dispute to resolve. As Freedland points out, there soon will be other blood tests for other kinds of cancer.
"This issue is something we need to keep in mind as we move forward with blood-based cancer screening," Freedland says.
Freedland and colleagues report their findings in the Nov. 21 issue of The Journal of the American Medical Association.
By Daniel DeNoon
Reviewed by Louise Chang
©2007 WebMD, Inc. All rights reserved.
Best-selling author Mitch Albom on his first nonfiction work since "Tuesdays with Morrie."





Super-size your meals and you super-size yourself and suffer the consequences of doing so.
Other countries can join us on a fight against global obesity.
In Brazil we are suggesting to increase fruit trees in the public area and change our country to a large tropical orchard. Then, sidewalks, squares, parks, roadsides will be plenty of free fruits bearing the most delicious and appropriate food to fight obesity.
We believe Brazil can tackle obesity and be the leader on such fight. We intend the rural area conquer the cities make it full of fruits.
http://revver.com/watch/225528
Even carnivores can be convinced to eat more fruits:
http://revver.com/watch/218695
Why not humans can eat fruits for their own good?