Impact of Metabolic Factors on Screening, Early Detection, and Management of Prostate Cancer

Abstract

In this chapter, we review the influence of energy imbalance on prostate cancer screening, diagnosis, and management. The influence of obesity on prostate cancer screening, diagnosis, and management is substantial and complex. Obese men have lower serum PSA, a tool to used to screen for prostate cancer, and larger prostate volume, which may lead to a reduced likelihood that an extant, but occult tumor without lethal potential is ever detected, while that same delay may lead to more advanced stages of disease at diagnosis and corresponding increases in prostate cancer mortality. Obesity can adversely affect the efficacy and safety of the treatment of prostate cancer with surgery or radiation. Development of an optimal framework to guide decision-making for prostate cancer screening, risk stratification, and management in obese men is needed.