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Biopsy may Underestimate Prostate Cancer in Obese and Overweight Men

study was funded by the Department of Veterans Affairs, the National Institutes of Health, the Georgia Cancer Coalition and the American Urological Association Foundation.

Prostate cancer is the second most common cancer, following skin cancer, in men in the United States, and a man has a one-in-six chance of being diagnosed with prostate cancer at some point during his life, according to the Prostate Cancer Foundation. Obese men diagnosed with the disease are 20 percent more likely to die from it than men of healthy weight.

Doctors typically conduct a biopsy when cancer is indicated by screening tests, such as a blood test for PSA, or by an irregular finding on a digital rectal exam. To perform a biopsy, a physician inserts a needle into the prostate and removes tissue for analysis.

In the study, the researchers analyzed data on more than 1,100 men who underwent surgery between 1996 and 2005 to remove the prostate gland, a common treatment for prostate cancer. They compared the aggressiveness of each patient’s cancer as suggested by examination of samples obtained during diagnostic biopsy with the actual aggressiveness of disease found by microscopic examination of the diseased prostate tissue removed at the time of surgery.

Obese men were 89 percent more likely than healthy weight men to have a more aggressive form of prostate cancer than was indicated by biopsy, Freedland said. Men with a body mass index (BMI) greater than 30 are considered obese. BMI is a measurement of weight adjusted for height. On this scale, a five-foot, 11-inch man weighing more than 215 pounds would be obese.

The researchers also found that men who were overweight but not obese were 44 percent more likely to have aggressive cancers than suggested by biopsy. Men with a body mass index between 25 and 29.9 are considered overweight; a five-foot, 11-inch man weighting more than 180 pounds would be overweight.

Freedland
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