Impact of Weight Management on Obesity-Driven Biomarkers of Prostate Cancer Progression

No AccessJournal of UrologyOriginal Research Articles1 Apr 2024Impact of Weight Management on Obesity-Driven Biomarkers of Prostate Cancer ProgressionThis article is commented on by the following:Editorial Comment Misty D. Bechtel, Carrie Michel, Pugazhendhi Srinivasan, Prabhakar Chalise, William P. Parker, Moben Mirza, Brantley Thrasher, Heather D. Gibbs, John DiGiovanni, and Jill Hamilton-Reeves Misty D. BechtelMisty D. Bechtel , Carrie MichelCarrie Michel , Pugazhendhi SrinivasanPugazhendhi Srinivasan , Prabhakar ChalisePrabhakar Chalise , William P. ParkerWilliam P. Parker , Moben MirzaMoben Mirza , Brantley ThrasherBrantley Thrasher , Heather D. GibbsHeather D. Gibbs , John DiGiovanniJohn DiGiovanni , and Jill Hamilton-ReevesJill Hamilton-Reeves Corresponding Author: Jill Hamilton-Reeves, PhD, RD, CSO, Department of Urology, University of Kansas, 3901 Rainbow Blvd, Kansas City, KS 66160 ([email protected]) https://orcid.org/0000-0002-0973-1542 View All Author Informationhttps://doi.org/10.1097/JU.0000000000003849AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Excess body and visceral fat increase the risk of death from prostate cancer (PCa). This phase II study aimed to test whether weight reduction by > 5% total body weight counteracts obesity-driven PCa biomarkers. Materials and Methods: Forty men scheduled for prostatectomy were randomized into intervention (n = 20) or control (n = 20) arms. Intervention participants followed a weight management program for 4 to 16 weeks before and 6 months after surgery. Control participants received standardized educational materials. All participants attended visits at baseline, 1 week before surgery, and 6 months after surgery. Circulating immune cells, cytokines, and chemokines were evaluated. Weight loss, body composition/distribution, quality of life, and nutrition literacy were assessed. Prostate tissue samples obtained from biopsy and surgery were analyzed. Results: From baseline to surgery (mean = 5 weeks), the intervention group achieved 5.5% of weight loss (95% CI, 4%-7%). Compared to the control, the intervention also reduced insulin, total cholesterol, LDL cholesterol, leptin, leptin:adiponectin ratio, and visceral adipose tissue. The intervention group had reduced c-peptide, plasminogen-activator-inhibitor-1, and T cell count from baseline to surgery. Myeloid-derived suppressor cells were not statistically different by group. Intervention group anthropometrics improved, including visceral and overall fat loss. No prostate tissue markers changed significantly. Quality of life measures of general and emotional health improved in the intervention group. The intervention group maintained or kept losing to a net loss of 11% initial body weight (95% CI, 8%-14%) at the study end. Conclusions: Our study demonstrated improvements in body composition, PCa biomarkers, and quality of life with a weight management intervention. REFERENCES 1. . Adiposity and risk of prostate cancer death: a prospective analysis in UK Biobank and meta-analysis of published studies. BMC Med. 2022; 20(1):143. Crossref, Medline, Google Scholar 2. . Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis. Transl Androl Urol. 2020; 9(6):2713-2722. Crossref, Medline, Google Scholar 3. . Weight gain is associated with an increased risk of prostate cancer recurrence after prostatectomy in the PSA era. Cancer Prev Res (Phila). 2011; 4(4):544-551. Crossref, Medline, Google Scholar 4. . Postdiagnosis body mass index, weight change, and mortality from prostate cancer, cardiovascular disease, and all causes among survivors of nonmetastatic prostate cancer. J Clin Oncol. 2020; 38(18):2018-2027. Crossref, Medline, Google Scholar 5. . Feasibility of a weight management program tailored for overweight men with localized prostate cancer—a pilot study. Nutr Cancer. 2021; 73(11-12):2671-2686. Crossref, Medline, Google Scholar 6. . Exploration of biomarkers from a pilot weight management study for men undergoing radical prostatectomy. Urol Oncol. 2021; 39(8):495.e7-495.e15. Crossref, Medline, Google Scholar 7. . Increased inflammatory low-density neutrophils in severe obesity and effect of bariatric surgery: results from case-control and prospective cohort studies. EBioMedicine. 2022; 77:103910. Crossref, Medline, Google Scholar 8. . Intentional weight loss and obesity-related cancer risk. JNCI Cancer Spectr. 2019; 3(4):pkz054. Crossref, Medline, Google Scholar 9. . Interventions that cause weight loss and the impact on cardiovascular risk factors: a systematic review and meta-analysis. Obes Rev. 2016; 17(10):1001-1011. Crossref, Medline, Google Scholar 10. . Obesity, prostate-specific antigen nadir, and biochemical recurrence after radical prostatectomy: biology or technique? Results from the SEARCH database. Eur Urol. 2012; 62(5):910-916. Crossref, Medline, Google Scholar 11. . Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011; 4(4):486-501. Crossref, Medline, Google Scholar 12. . Presurgical weight loss affects tumour traits and circulating biomarkers in men with prostate cancer. Br J Cancer. 2017; 117(9):1303-1313. Crossref, Medline, Google Scholar 13. . Phase II prospective randomized trial of weight loss prior to radical prostatectomy. Prostate Cancer Prostatic Dis. 2018; 21(2):212-220. Crossref, Medline, Google Scholar 14. . Low-fat, low-glycemic load diet and gene expression in human prostate epithelium: a feasibility study of using cDNA microarrays to assess the response to dietary intervention in target tissues. Cancer Epidemiol Biomarkers Prev. 2007; 16(10):2150-2154. Crossref, Medline, Google Scholar 15. . Efficacy of a weight loss program prior to robot assisted radical prostatectomy in overweight and obese men with prostate cancer. Surg Oncol. 2020; 35:182-188. Crossref, Medline, Google Scholar 16. . A study of caloric restriction versus standard diet in overweight men with newly diagnosed prostate cancer: a randomized controlled trial. Prostate. 2013; 73(12):1345-1351. Crossref, Medline, Google Scholar 17. . Serum insulin, glucose, indices of insulin resistance, and risk of prostate cancer. J Natl Cancer Inst. 2009; 101(18):1272-1279. Crossref, Medline, Google Scholar 18. . Inflammatory and insulinemic dietary patterns: influence on circulating biomarkers and prostate cancer risk. Cancer Prev Res (Phila). 2020; 13(10):841-852. Crossref, Medline, Google Scholar 19. . Serum lipid profile and risk of prostate cancer recurrence: results from the SEARCH database. Cancer Epidemiol Biomarkers Prev. 2014; 23(11):2349-2356. Crossref, Medline, Google Scholar 20. . Biomarkers associated with tumor Ki67 and cathepsin L gene expression in prostate cancer patients participating in a presurgical weight loss trial. Front Oncol. 2020; 10:544201. Crossref, Medline, Google Scholar 21. . Inflammation and nutrition: friend or foe?. Nutrients. 2023; 15(5):1159. Crossref, Medline, Google Scholar Funding/Support: This research was supported by grant P30CA168524 from the National Cancer Institute and by research scholar grant 130465-RSG-17-050-01-NEC from the American Cancer Society (Dr Hamilton-Reeves), and used the Nutrition, Biostatistics and Informatics, Biospecimens, and Flow Cytometry Shared Resources. The contents are solely the authors' responsibility and do not necessarily represent the official views of the NIH or ACS. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. STUDY00141060). All human subjects provided written informed consent with guarantees of confidentiality. Author Contributions:Conception and design: Hamilton-Reeves, Bechtel, Chalise, Parker, Mirza, Gibbs, DiGiovanni. Data analysis and interpretation: Hamilton-Reeves, Bechtel, Srinivasan, Chalise, Parker, Mirza, Gibbs. Data acquisition: Hamilton-Reeves, Bechtel, Michel, Srinivasan, Mirza, Thrasher. Drafting the manuscript: Hamilton-Reeves, Bechtel, Michel, Srinivasan, Chalise. Critical revision of the manuscript for scientific and factual content: Hamilton-Reeves, Bechtel, Srinivasan, Chalise, Parker, Mirza, Thrasher, Gibbs, DiGiovanni. Statistical analysis: Hamilton-Reeves, Srinivasan, Chalise. Supervision: Hamilton-Reeves, Bechtel, Mirza. Editor's Note: This article is the second of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 641 and 642. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySiemens D (2024) Editor's ChoiceJournal of Urology, VOL. 211, NO. 4, (507-508), Online publication date: 1-Apr-2024.Related articlesJournal of Urology1 Feb 2024Editorial Comment Volume 211Issue 4April 2024Page: 552-562 Peer Review Report Open Peer Review Report Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Keywordsprostate cancerobesityvisceral fatweight lossquality-of-lifeAcknowledgmentsWe thank Hilary Robertson, Shelby Rissler, Jessica Keller, Emily Newbold, Loran Griffith, Nicole Cortez, and Alyssa Mattox for coaching; Chelsea Johnson, Luke Bartl, and Rita-Marie McFadden for lab work; and the University of Kansas Clinical Research Center staff for help with clinic visits. We thank Rich Hastings, Andrew Godwin, and Rashna Madan for their technical assistance, and Weiya Liu for editing. We acknowledge the deceased Dr Yankee for guiding our immune analysis. Lastly, we thank the patient research advocates who helped codesign our study: Jerry Stevens, Greg Walkup, Rick Larsen, and Bob Walrafen.Metrics Author Information Misty D. Bechtel More articles by this author Carrie Michel More articles by this author Pugazhendhi Srinivasan More articles by this author Prabhakar Chalise More articles by this author William P. Parker More articles by this author Moben Mirza More articles by this author Brantley Thrasher More articles by this author Heather D. Gibbs More articles by this author John DiGiovanni More articles by this author Jill Hamilton-Reeves Corresponding Author: Jill Hamilton-Reeves, PhD, RD, CSO, Department of Urology, University of Kansas, 3901 Rainbow Blvd, Kansas City, KS 66160 ([email protected]) More articles by this author Expand All Funding/Support: This research was supported by grant P30CA168524 from the National Cancer Institute and by research scholar grant 130465-RSG-17-050-01-NEC from the American Cancer Society (Dr Hamilton-Reeves), and used the Nutrition, Biostatistics and Informatics, Biospecimens, and Flow Cytometry Shared Resources. The contents are solely the authors' responsibility and do not necessarily represent the official views of the NIH or ACS. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. STUDY00141060). All human subjects provided written informed consent with guarantees of confidentiality. Author Contributions:Conception and design: Hamilton-Reeves, Bechtel, Chalise, Parker, Mirza, Gibbs, DiGiovanni. Data analysis and interpretation: Hamilton-Reeves, Bechtel, Srinivasan, Chalise, Parker, Mirza, Gibbs. Data acquisition: Hamilton-Reeves, Bechtel, Michel, Srinivasan, Mirza, Thrasher. Drafting the manuscript: Hamilton-Reeves, Bechtel, Michel, Srinivasan, Chalise. Critical revision of the manuscript for scientific and factual content: Hamilton-Reeves, Bechtel, Srinivasan, Chalise, Parker, Mirza, Thrasher, Gibbs, DiGiovanni. Statistical analysis: Hamilton-Reeves, Srinivasan, Chalise. Supervision: Hamilton-Reeves, Bechtel, Mirza. Editor's Note: This article is the second of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 641 and 642. Advertisement PDF downloadLoading ...