To the many health problems that come with packing on the pounds, men can add another: prostate cancer. And, according to a recent state report, Georgia men have more to worry about because nearly two-thirds of them are overweight or obese.
In a study being presented this week at the annual meeting of the American Urological Association, a Medical College of Georgia researcher found that a higher body mass index increased the odds of having an aggressive form of the cancer. Many prostate cancers respond to hormones, and obesity throws off hormone levels in the body, said Martha K. Terris, a researcher at MCG and the Augusta Department of Veterans Affairs Medical Centers.
"Fat tissue tends to convert certain steroids in the body to estrogenlike compounds," Dr. Terris said. "It feeds aggressive prostate cancer, or it allows aggressive prostate cancers to grow more."
She was presenting another study that showed smaller prostates were associated with more aggressive cancers and that the prostate might be smaller because of lower levels of male hormones resulting from obesity.
Part of the reason might also be that obesity makes it more difficult to detect the cancers, Dr. Terris said.
"The PSA blood test that we check to screen for prostate cancer may not be as reliable in obese men because it too is influenced by the hormones that may be produced by adipose (fat tissue)," she said. "If there is more estrogen in the body, produced by the adipose tissue, then the prostate cells, cancer cells or benign cells, don't produce as much of the PSA protein."
About 65 percent of men are overweight or obese in Georgia, according to a recent report from the Georgia Department of Human Resources. And prostate cancer is already the second-leading cause of cancer deaths in Georgia men, said Stuart T. Brown, the acting director of the Georgia Division of Public Health.
"It's quite an important priority for us in public health and at the Georgia Cancer Coalition," Dr. Brown said. "Over the recent years, the link to obesity has been made in a number of studies. The findings are quite clear - obesity and ever-increasing obesity increases the risk for a number of cancers, one of them being prostate cancer."
Obesity should add to the risk factors doctors consider when evaluating patients for prostate cancer, Dr. Terris said.
"Certainly in men that are at risk for prostate cancer, that is African-Americans or men with a family history of prostate cancer, if they are obese and their PSA levels may be slightly elevated or higher than you would expect for their age, perhaps those should be referred for a biopsy or more in-depth testing than maybe somebody that was a normal weight individual," she said.
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The rising tide of obesity in Georgia is a major concern for public health officials. The percentage of overweight and obese adults in Georgia increased from 37 percent in 1984 to 59 percent in 2002, including 65 percent of men, according to a recent state report. Obesity has been linked to a number of diseases, including prostate cancer. Stuart T. Brown, the acting director of the Georgia Division of Public Health, addressed obesity in Georgia and the state's plan to combat it. A comprehensive 10-year state plan will be released in June. These are Dr. Brown's comments from an interview:
- On obesity and how being overweight accounting for an estimated 6,700 deaths a year:"It is absolutely devastating, contributing to diabetes, cardiovascular disease, stroke, heart attacks and any number of degenerative joint diseases. The fact that the percent of the population that is obese and overweight has increased 60 percent in the last two decades is really shocking and it's causing major health consequences and I'm sure resulting in enormous costs to our health care system."
- On strategies to get people to eat less: "That is, how do we get people to assume that a smaller serving size is the correct size? How do we get people to think that the fats and gravies that we all love so much may be best left on the plate? And we need to be putting more veggies on those plates."
- On getting people to exercise more, whether on their own or in groups at school or at work: "Can we get more individuals out doing just a little more activity today than you did yesterday, whether it's walking or whether it's simply having a trip around the floor that you work on in between sessions at your computer? If we could make our shopping centers and our residences closer together, we might spend a little less time in our automobiles. If we could increase the number of sidewalks or safe walking areas, we might increase the use of your feet. If we had bike trails that encouraged people to bicycle instead of using an automobile, again, we're looking for ways that our built environment can help us."