A second report from Duke in the same issue of the journal found that excess weight influenced the outcome of surgery for prostate cancer. Men with a BMI of 35 or higher were nearly 60 percent more likely to have a recurrence of the cancer than thinner men, the study of 1,434 men found.
One reason is "the difficulty of operating on obese men in general," said study author Dr. Jayakrishnan Jayachandran, a urology oncology fellow at the Duke Prostate Cancer Center. "The prostate is a narrow thing to operate on, and when there is a big wad of fat in your way, if the abdominal wall is thick, it becomes a technical issue."
The result is that not all the cancer may be removed, which means a recurrence after time, Jayachandran said. "The only thing we can think of is that when you operate on obese people, you have to be more careful," he said.
The studies results apply to men who might not regard themselves as obese, Freedland said. "We can't forget that when we use the term, we are not just talking about very large men," he said. "A man who is 5 foot 9 and weighs 203 pounds would be considered obese."
Jayachandran added, "We are not screening these obese men effectively and are not doing as good a job surgically as could be done."
To learn more about prostate cancer, visit the U.S. National Cancer Institute.
SOURCES: Stephen Freedland, M.D., associate professor, urology and pathology, Jayakrishnan Jayachandran, M.D., urology oncolgy fellow, Duke University Prostate Cancer Center, Durham, N.C.; Aug. 8, 2008, BJU International, online
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