Being overweight can delay the diagnosis of prostate cancer
Because the PSA diluted in the blood and the prostate is larger, you should start with overweight the PSA threshold for biopsy lower and / or more samples taken at biopsy, according to a new study.
To screen for prostate cancer, the PSA test is very often used (for details see PSA test ).However, the result can lead to a so-called overdiagnosis, ie unnecessary further investigations. Therefore, it is important to know what can affect the PSA level in the blood.Obesity is on the rise worldwide and currently affects nearly one in three adults, a significantly higher proportion in the U.S. and Europe. It could affect the detection of prostate cancer, in particular by an impact on the PSA level and the prostate size.
It is known that obese men have lower PSA levels than other men, may be caused by lower levels of testosterone (male sex hormone) and / or by dilution of PSA in a larger volume of blood. In addition, to be discovered in obese prostate cancer rather at a later stage. This suggests that the prostate size is an issue and the biopsy (sampling) is later recommended (see also later diagnosed with cancer in overweight? ).
To review previous studies and to determine in particular the effect of a change in body weight, serum PSA level and prostate volume over time, a new study was performed: this 40-79 year old men were from the U.S. state of Minnesota from 1990 all two years studied, a total of up to eight times. One particular body size, body weight, serum PSA level and prostate volume (the latter with ultrasound, see TRUS ) and calculated the volume of blood fluid (blood plasma) and the therein PSA amount. 545 men with at least two measurements were ultimately included in the evaluation.
The results showed that men with a least significant overweight (a BMI of 30, see overweight ) compared to the less severely obese had a lower PSA levels (blood levels) and this increase more slowly over time. Both make a decision to biopsy unlikely and is at least partly due to a dilution effect back. For the overweight had a higher plasma volume, but no greater PSA total, both at the beginning and in the further course. However, their prostate volume was higher, even the hit rate of the biopsy statistically reduced if a malignant tumor is present.
Conclusion of the authors
In the assessment of PSA levels and the recommendation for prostate biopsy, the patient's body weight should be taken into account. In obesity, the discovery of a possible prostate cancer could be delayed because the PSA diluted in the blood and the prostate is larger.Therefore, it would be useful to the PSA threshold for biopsy in overweight (Note: Depending on the measurement method normally eg 4ng/ml) be lower and / or to take more samples from the biopsy.
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