Dr. Wagaskar on Potential Explanations for the Obesity Paradox in Prostate Cancer

Vinayak G. Wagaskar, MBBS, instructor of urology, Mount Sinai, discusses potential explanations for a paradoxical relationship between obesity and outcomes observed in prostate cancer.

Findings from a retrospective study, which were presented during the 2021 EAU Congress, demonstrated that patients with metastatic castration-resistant prostate cancer with an elevated body mass index (BMI) had a higher survival probability vs overweight and normal weight patients.

Elevated BMI could be attributed to increased fat mass or lean muscle mass, says Wagaskar. Patients with a high BMI from lean muscle mass could have improved cardiac function, which could contribute to improved outcomes with prostate cancer, explains Wagaskar. The study presented during the 2021 EAU Congress did not specify whether patients’ elevated BMI was caused by fat or lean muscle mass, Wagaskar adds.

Additionally, the patients analyzed likely experienced weight gain as an adverse effect associated with prior hormone therapy or chemotherapy, Wagaskar says. Obese patients were also younger, which could attribute to the improvement in outcomes observed, concludes Wagaskar.