PSA Tests May Be Misleading For Obese Men
When testing for prostate-specific antigen (PSA) — which screens for prostate cancer in men — doctors and patients may be misled by the results for obese men.
That’s because obese men often have lower PSA levels than normal-weight men.
Researchers at Duke Prostate Center and the Durham Veterans Affairs Medical Center believe this happens because obese men have greater volumes of blood which dilute the PSA levels.
By giving a false impression of cancer status, these lower PSA levels may be responsible for the delayed diagnosis of prostate cancer in obese men. And worst of all, their cancer may be much more aggressive and widespread by the time it is identified.
The researchers studied almost 3400 men over the last 8 years. They compared the outcomes for men who had prostate cancer found by PSA tests versus by abnormal digital rectal exams.
Their conclusion: obese men who were diagnosed through PSA screening had over 2 times the risk of cancer recurrence after surgery than normal-weight men.
But when obese men were diagnosed through abnormal digital rectal exams, the risk of cancer recurrence after surgery was about the same as normal-weight men.
Another Duke study concluded that prostate surgery may be more technically difficult in obese men as well. By that, they meant that tumors were harder to remove completely. So there was a greater probability of cancer being left behind in obese men.
So obese men get hit twice: once because their tumors are more aggressive and the second time because those tumors are harder to surgically remove.
What should obese men do?
If you’re an obese man, you may want to talk to your doctor about alternative prostate cancer screening methods. Maybe a digital rectal exam should be considered along with a PSA screening.
Or maybe lower PSA levels should be flagged for further analysis in obese men.
For now, unfortunately, there are no standardized medical rules to help with PSA screening, prostate cancer and obese men.
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