Peri-Prostatic Adipose Tissue.

[pjoshea13]

New review below [1].

Details are in the full text, but it's a reminder that visceral fat secretes hormones that can spur PCa growth.

A number of studies have measured periprostatic fat thickness & found that it has prognostic value. Which implies that it has an active role in progression.

"... several recent studies have identified secreted factors from both the {peri-prostatic adipose tissue} and PCa that potentially mediate the two-way communication between these intimately-linked tissues."

There are now many studies that link obesity to poorer PCa survival. Two things that I don't like about the studies:

1] Most of us do not have a BMI of 30 or over, so might feel safe. However, there is danger too for overweight men (BMI = 20-29.9).

2] BMI is easy to measure and acts as a surrogate for visceral fat, which can only be measured via a scan. Some men have high BMIs but little visceral fat, while others are slim but with a lot of visceral fat.

For men who have insulin resistance (triglycerides > twice HDL-cholesterol is a decent surrogate), excess triglycerides from a high-carb diet are preferentially dumped from the circulation into visceral fat stores. Slim men on a Dean Ornish-type low-fat diet will be unaware that their internal organs may be loaded with fat - the TOFI phenomenon [2].

For men who have had the prostate removed, periprostatic fat is no longer a concern, but fat around the other organs act as an uncontrolled gland in the endocrine system, with a growth effect on PCa cells.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/294...

BJU Int. 2018 Feb 20. doi: 10.1111/bju.14173. [Epub ahead of print]

Peri-Prostatic Adipose Tissue: The metabolic microenvironment of prostate cancer.

Nassar ZD1,2,3, Aref AT1,2,3, Miladinovic D4, Mah CY1,2,3, Raj GV5, Hoy AJ4, Butler LM1,2.

Author information

Abstract

Emerging data has linked certain features of clinical prostate cancer (PCa) to obesity and, more specifically, increased adiposity. Whereas the large number of clinical studies and meta-analyses that have explored the associations between PCa and obesity have shown considerable variability, particularly in relation to prostate cancer risk, there is an accumulating weight of evidence consistently linking obesity to greater aggressiveness of disease. In probing this association mechanistically, it has been posited that the peri-prostatic adipose tissue (PPAT), a significant component of the prostate microenvironment, may be a critical source of fatty acids and other mitogens and thereby influences PCa pathogenesis and progression. Notably, several recent studies have identified secreted factors from both the PPAT and PCa that potentially mediate the two-way communication between these intimately-linked tissues. In this review, we summarise the available literature regarding the relationship between PPAT and PCa, including the potential biological mediators of that relationship, and explore emerging areas of interest for future research endeavours. This article is protected by copyright. All rights reserved.

KEYWORDS:

Prostate cancer; adipocytes; obesity; peri-prostatic adipose tissue; tumour microenvironment

PMID: 29460324 DOI: 10.1111/bju.14173

...

[2] theguardian.com/science/200...

[Dr_WHO]

Oh boy. Been on hormonal therapy for about a year and a half. Even though I exercise (road over 1000 miles on my bike last year, work out at the Y 5days a week, etc.) I have put on over 20 pounds of fat. Actually it is more than that if you take into account the amount of muscle mass that I have lost.

Perhaps it is time for the bread and water diet.....

[pjoshea13 in reply to Dr_WHO]

Not bread. How about duck confit & water? LOL -Patrick

[RJ-MN]

I have now been on Lupron injections for 7.5 years. No Mayo Clinic oncologist will even discuss going off it for stage IV; it is unbendingly the "Mayo Clinic protocol" for my situation. Also, the NIH clinical trial I've been on for almost 4 years now (enzalutamide plus ProstVac-Tricom) requires it. So I deal with a 15-20 pound weight gain from when I started. I still do 60 minutes on the elliptical almost every day when home and watch my carbs, but I think we'd gain fat even on the hay and water.

[j-o-h-n]

Well anyway I went to MSKCC for a test last Tuesday. As the technician was guiding me into the "Testing Room" I told him that they should have some Viagra and Cialis and couple of pole dancers, and some lap dancers in the waiting room and about eight hours of wait time before they call me in for my BONER DENSITY TEST. He gave me such a look, I'll never forget it.

Good Luck and Good Health.

j-o-h-n Thursday 02/22/2018 4:26 PM EST

[Hidden]

BMI is sometimes a little questionable for those of us who work out and try to add muscle. I guess measuring body fat percentage is the way to go: bodybuilding.com/content/ho...

I haven't done it yet myself. My BMI is just under 25. I think I would be discouraged at my body fat percentage.