“This obesity paradox has been seen in some other cancers, possibly due to the relationship between tissue fat and cancer genomes, and more research is needed in this area,” Fossati says in a news release.
On the other hand, he adds, the findings might reflect some interaction between cancer chemotherapy and other medications.
“Obese patients in this older age group tend to be taking medication for other conditions,” Fossati notes, “and we do not fully understand how these medicines interconnect.”
Dr. Peter Albers, chair of the EAU’s Scientific Congress Office, also cautioned that the reasons behind the obesity paradox, in general, are uncertain.
“It might be that patients with higher BMI are able to tolerate the toxicity of the treatments and their side effects better,” Albers says in the release. “In prostate cancer, it might be due to the protective impact of hormones found in tissue fat; and it is known that healthy men with slightly higher BMI have a higher overall life expectancy compared to very slim ones.”
But, he stressed, that’s all conjecture.
“Further research is needed to identify the biological mechanism behind these different outcomes,” Albers says. “Until that mechanism is proven, we can’t recommend any change to treatment for patients with advanced prostate cancer.”
In fact, Wagaskar says, some other studies have linked obesity not only to a higher risk of developing prostate cancer but also to “worse cancer-related outcomes.”
Fossati agreed that a healthy weight range should be the goal. “Obesity is a risk factor for many cancers and other diseases,” he says, “and patients should always aim for a healthy BMI of 18 to 24.”