Prostate cancer occurs at the site of the prostate in men. A healthy prostate is a small walnut-shaped gland that produces fluids for semen. In prostate cancer, the prostate cells begin to grow uncontrollably and form an unwanted tumour. It occurs in older men, but the severity of the cancer and the speed of growth of the tumour differs from person to person, with the factors that contribute to the cancer's potential development being varied.

The factors which are all uncontrollable and contribute to an increased likelihood of developing prostate cancer:

• Age – 50 years and above
• Ethnicity – African-Americans have an increased likelihood of being diagnosed with aggressive forms of the disease, whereas Asian and Hispanic men are less likely than Caucasian or African American men)
• Genes – a family history of prostate cancer increases the likelihood of developing the disease

Whilst these factors are uncontrollable, weight, specifically being overweight, is known to increase chances of the potentially fatal disease. It is crucial for men approaching 50 or those who fall into any of the categories above and are overweight or obese, to start to lose weight.

Despite the knowledge that we can control our weight, 43% of adults worldwide are overweight,¹Itis essential to have a fundamental understanding of the significant role fat plays in prostate cancer. Here we delve into all you need to know about what links prostate cancer with weight and how to start to manage your weight.

Understanding the prostate and prostate cancer

The prostate

Prostate cancer follows a very defined pattern in its progression. To understand prostate cancer, we need to know the anatomy of the gland. Imagine the prostate as a petrol station. Fluid produced by the prostate is much like additives added to petrol that increase the performance of a car; that preserves, and nourishes sperm, increasing their efficiency. 

Specialised tissue in the prostate made up of rigid muscular cells, are in place to support the prostate’s operations, much like the structural support provided by petrol pumps. There is also a depot for fat on the pancreas which is like our stocking point for the lorries to come and fill the fuel containers so that the station doesn’t run out of petrol.

Finally, liquids pass through a hollow tube in the prostate called the lumen. These liquids come from the bladder during urination, and from the testis during ejaculation, much like how fuel hoses contain a hollow tube to allow petrol to flow from the pump to the car. Every part of the prostate benefits from its function, much like the components of a petrol station facilitate loading fuel into a car.

Prostate cancers progression

All cancer cells replicate uncontrollably and form a tumour. A common observation in prostate cancer, is the cells that surround the lumen (the hollow tube of our petrol hose) begin on this uncontrollable replication frenzy. Imagine somehow that the rubber hose has built up more rubber within the space that petrol passes through in our hose. It is what occurs with the cells in the lumen of the prostate. 

The cells begin to grow uncontrollably and change the shape of the prostate outside of the lumen, meaning when looking at our petrol station, major malfunction lumps are visible on the petrol hose, pump, and overall station. 

Now, the cancerous cells have replicated so much that they could be close to blood vessels in the body and can potentially lead to the cancerous cells entering the bloodstream and unfortunately spreading a cancer that started in the bloodstream, to anywhere in the body that they can get a grip onto. 

The cancer cells can migrate to the lungs, liver, bone brain or to any body part. t In this stage the cancer becomes extremely hard to treat. It is this variant of prostate cancer that is considered aggressive and has been seen more commonly in studies of large cohort groups to be correlated with individuals with excessive body fat.^2,3

Importance of fat

We all have fat, that plays a vital role in the body. Today we have comfortable living and a sedentary lifestyle. The food is readily available, so obesity is increasing.

The scientific/medical world is beginning to consider fat as an organ.⁴ Fat impacts chemicals like hormones, molecules affecting inflammation, and the immune system. Therefore, if we have too much fat, the vital systems in the body can swing out of balance, causing a greater risk of cancer.⁵

Weight and prostate cancer: correlation and causation

Obesity associated-prostate cancer risks

The more overweight an individual is, the higher the likelihood of them encountering a more severe form of prostate cancer.

Inflammation

Excess fat leads to a constant low level of inflammation across the body, which can increase the likelihood of cancer. When we look specifically at prostate cancer, we know that the prostate has a depot for fat storage that plays an important role in hormonal activity, inflammation, and nutrient supply to the prostate.

Studies prove that with more fat in this depot the likelihood of developing prostate cancer increases.⁶ Additionally this depot of the prostate has proven to communicate with prostatic cancer cells and help them to grow and migrate.^7,8 To reduce fat storage in this depot and avoid these harmful occurrences in the body – one should aim to lose weight.

Hormones

Hormones travel around the body in the blood and are present for specific purposes to aid a healthy individual with normal function of the body. Leptin is a hormone released by fat storage. It causes satiety (feeling full and feeling good about the food you have just eaten), energy usage, and controls body weight.

An overweight individual has more leptin circulating around the body, leading to leptin resistance (so the body cannot take up energy correctly) and contributes to inflammation.⁹ Studies have shown increased leptin to increase replication (growth) and migration of prostate cancer cells.^10,11

Similarly, other hormones such as Adiponectin, Visfatin, FGF21, and Insulin-like Growth Factor have health functions affected in overweight individuals. These are linked in literature with increased chances of developing prostate cancer, stressing the need to be conscious of weight to avoid the disease.^{12,13,14,15,16}

Weight management in prostate cancer prevention

Weight has a massive part to play in prostate cancer development, so individuals need to come up with a plan to manage their weight and give themselves the best chance of avoiding the disease.

Diet

Certain delicious foods contain nutrients that greatly benefit the prostate and are healthy alternatives to highly processed, fat-heavy unhealthy foods.

• Tomatoes, watermelon, pink grapefruits and any other red fruit contain lycopene, an antioxidant which fights the negative effects of consistent inflammation
• Fish like salmon, trout or mackerel; or superfoods such as chia seeds, walnuts, or flaxseeds all are high in omega-3 fatty acids that reduce inflammation and lower the risk of prostate cancer
• Red meat, beans and shellfish are packed with zinc, which supports the prostate and is vital to its health
• Vitamins E & D are essential for prostate cells to function and can be supplemented or found in foods such as nuts and seeds for vitamin E; and fatty fish or just plain sunlight exposure for vitamin D
• A Mediterranean diet, or a low carb diet prevents cancer.

Exercise

Regular exercise, going for an extra 30-minute walk each day and then increasing the intensity has benefits in losing weight and preventing prostate cancer. 

It is also widely known that losing weight and exercising benefit mental health. Staying lean helps you feel better.

We should aim for 4 hours of exercise per week, 2.5 hours of moderate intensity like brisk walking, cycling or dancing, and 1 hour 15 minutes of high intensity like jogging, playing a sport or fast cycling. That’s the goal, initially any form of exercise is better than nothing!

Summary

Hopefully, you now have a strong understanding of why prostate cancer is linked with weight. We have an arsenal of tools available to help you manage weight loss to avoid the horrible disease. By eating right and exercising well, you will not only decrease inflammation in the body and improve hormonal pathways to reduce the chances of prostate cancer but also improve your overall health and day-to-day life.