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Race, Obesity Affect Outcomes Among Diabetics Following Prostatectomy DURHAM, NC -- January 11, 2010 -- Obese white men who have both diabetes and prostate cancer have significantly worse outcomes following radical prostatectomy than do men without diabetes who undergo the same procedure, according to a study published in Cancer Epidemiology, Biomarkers & Prevention. Many studies have shown that diabetes is associated with a lower risk of developing prostate cancer -- at least in white men -- but the effect of diabetes on outcomes after prostate cancer surgery has not been as clear. “We found that diabetes was significantly associated with more aggressive disease in obese white men and less aggressive disease for all other subsets of men in our study,” said Stephen Freedland, MD, Duke Prostate Center, Duke University, and Veterans Affairs Medical Center, Durham, North Carolina. “Given that race and obesity are related to both aggressive prostate cancer and diabetes, we hypothesised that the association between diabetes and prostate cancer progression might vary by race and obesity.” The study examined the records of 1,262 men in the SEARCH database who underwent radical prostatectomy between 1988 and 2008. Researchers tracked the impact of diabetes upon tumour grade, the likelihood of recurrence, and the amount of time it took for the patients’ PSA level to double (PSADT) after surgery. They found no link between diabetes and prostate cancer progression. But in a secondary analysis, after sorting the data by race and weight, investigators found an association between diabetes and an increased risk of recurrence and a trend toward more aggressive recurrence (reflected in a shorter doubling time of the PSA) -- but only among obese white men. In all other subgroups, diabetes was associated with lower recurrence risk and longer PSADT. Dr. Freedland said this is the first study to examine racial and body weight differences in the association between diabetes and prostate cancer progression, therefore these findings need to be validated before drawing firm conclusions regarding any relationships. Because all men in the study were healthy enough to undergo surgery also means that the results may not be applicable to a general population. SOURCE: Duke University Medical Center E-mail this page to a friend or colleague! To print, use this version