Nov 20, 2007

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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(WebMD)  Obese men may have prostate cancer despite relatively low values on a prostate cancer screening test called the PSA test, a new study suggests.

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.

Quote

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,MD
""This is an over-interpretation of the data. Most studies show the difference is much smaller," Kristal tells WebMD. "Doctors will look not just at the PSA level but the speed of PSA increase over time, the PSA relative to other men the same age, findings from a digital rectal exam, and other information before they make a decision on whether to do biopsy. These teeny-tiny differences due to obesity have no impact."

It'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.
Add a Comment
by lonestartnow November 21, 2007 2:04 PM EST
This should be an eye-opener for men. Through our LoneStart Wellness Initiative, when we provide the program for employee work groups, it''s always amazing to me how many men seem to think "weight loss" and nutrition, and finding ways to become more physically active doesn''t apply to them--that weight loss is for women who want to look better. I''m certainly not saying this is true of all men, or that this is the motivation for women trying to lose weight, only that being overweight or obese has health consequences for everyone.
Reply to this comment
by formrusmcsgt November 21, 2007 10:47 AM EST
Bottom line:

Super-size your meals and you super-size yourself and suffer the consequences of doing so.
Reply to this comment
by tubarc November 21, 2007 6:58 AM EST
Fruits are low in calories and highly nutritional already grown on public places at increasing ratios to face obesity trends. Tree climbing also can be a body exercise for children harvesting fruits.

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?
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