Obesity is associated with aggressive prostate cancer. To explore whether weight loss favourably affects tumour biology and other outcomes, we undertook a presurgical trial among overweight and obese men with prostate cancer.
This single-blinded, two-arm randomised controlled trial explored outcomes of a presurgical weight loss intervention (WLI) that promoted ∼1 kg per week loss via caloric restriction and increased physical activity (PA). Forty overweight/obese men with clinically confirmed prostate cancer were randomised to the WLI presurgery or to a control arm; changes in weight, body composition, quality-of-life, circulating biomarkers, gene expression, and immunohistochemical markers in tumour and benign prostatic tissue were evaluated.
The study period averaged 50 days. Mean (s.d.) change scores for the WLI vs control arms were as follows: weight: -4.7 (3.1) kg vs -2.2 (4.4) kg (P=0.0508); caloric intake: -500 (636) vs -159 (600) kcal per day (P=0.0034); PA: +0.9 (3.1) vs +1.7 (4.6) MET-hours per day (NS); vitality: +5.3 (7.l4) vs -1.8 (8.1) (P=0.0491); testosterone: +55.1 (86.0) vs -48.3 (203.7) ng dl(-1) (P=0.0418); sex hormone-binding globulin: +14.0 (14.6) vs +1.8 (7.6) nmol l(-1) (P=0.0023); and leptin: -2.16 (2.6) vs -0.03 (3.75) (P=0.0355). Follow-up Ki67 was significantly higher in WLI vs control arms; median (interquartile range): 5.0 (2.5,10.0) vs 0.0 (0.0,2.5) (P=0.0061) and several genes were upregulated, for example, CTSL, GSK3B, MED12, and LAMC2.
Intentional weight loss shows mixed effects on circulating biomarkers, tumour gene expression, and proliferative markers. More study is needed before recommending weight loss, in particular rapid weight loss, among men with prostate cancer.British Journal of Cancer advance online publication: 7 September 2017; doi:10.1038/bjc.2017.303 www.bjcancer.com.
British journal of cancer. 2017 Sep 07 [Epub ahead of print]
Wendy Demark-Wahnefried, Soroush Rais-Bahrami, Renee A Desmond, Jennifer B Gordetsky, Gary R Hunter, Eddy S Yang, Maria Azrad, Andrew D Frugé, Yuko Tsuruta, Lyse A Norian, Roanne Segal, William E Grizzle
Department of Nutrition Sciences, Wallace Tumor Institute, University of Alabama at Birmingham, 1824 6th Avenue South, Suite 102, Birmingham, AL 35294, USA., University of Alabama at Birmingham Comprehensive Cancer Center, Wallace Tumor Institute, 1824 6th Avenue South, Birmingham, AL 35294, USA., Department of Urology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35233, USA., Department of Human Studies, University of Alabama at Birmingham, 901 13th Street South, Birmingham, AL 35294, USA., Department of Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.