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Examining the links between prostate cancer and obesity

Researchers from King’s College London have teamed up with colleagues in Ireland and Sweden to investigate why obesity makes prostate cancer more aggressive and to see whether a simple exercise programme can improve quality of life and prolong survival for advanced prostate cancer patients.
The study, which has received €300,000 from the World Cancer Research Fund, is led by Dr Stephen Finn, Associate Professor in Histopathology and Morbid Anatomy in Trinity College Dublin, with collaborators from King’s and The University of Orebro, Sweden. 
Worldwide, prostate cancer is the second most common cancer among men. In parallel with this rise in the incidence of prostate cancer has been a steady increase in obesity as a public health problem.
Dr Mieke Van Hemelrijck, Co-Director of the Cancer Epidemiology Group at King’s, says: ‘There is a growing body of evidence of the inter-relationship between changes in the metabolism of fat and the development and progression of prostate cancer. King’s Health Partners’ Prostate Cancer Network is utilising its existing expertise in this area to undertake and plan more detailed investigation of this possible link.

‘The aim of this work is to study how manipulating the breakdown of fat changes the ability of prostate cancer cells to spread outside the prostate. To further identify how fat metabolism related factors define the aggressive nature of a prostate tumour, the Network is relying on its Prostate Cancer Clinical database.

‘With this collaborative study on the link between the fat metabolism and prostate tumour biology, we aim to identify markers which can be used to define men prone to aggressive prostate cancer and predict patients’ responses to treatments. This will help clinicians and, most importantly, patients make more informed treatment choices. Furthermore, the identification of key markers associated with aggressive disease could lead to the identification of new therapies for prostate cancer.’
Dr Finn explains further: ‘In men with advanced cancer, individual cancer cells spread beyond the prostate gland and can be found floating in the blood. These cancer cells are known as ‘circulating tumour cells’ or CTCs. Tiny blood particles (platelets) become stuck to these CTCs  in a process called ‘platelet cloaking’ and may prevent the body's immune system from hunting down and killing the cancer cells before they can spread around the body. There is a greater tendency for blood to clot, due to stickier platelets, in obesity. This suggests that there may be more platelet cloaking of CTCs in overweight men with prostate cancer, which in turn makes the cancer more aggressive.’

The study aims to determine whether in prostate cancer there is more platelet cloaking of CTCs in men who are overweight compared to men who are not, whether regular exercise can improve quality of life and reduce platelet cloaking of CTCs; whether there are specific genes which make platelet cloaking worse; and whether platelet cloaking varies relative to measurements of how easily the blood clots.

Speaking about the significance of this study Dr Finn says: ‘Both obesity and prostate cancer are becoming a lot more common and the relationship between the two in an individual patient is becoming more important. We hope to show that a simple, low-cost exercise programme can improve quality of life and prolong life for advanced prostate cancer patients, and hopefully reduce the bad effects of being overweight on cancer outlook for these men. This project is hugely significant because it is one of the few efforts to identify a mechanism underlying the link between obesity and prostate cancer and indeed other cancers.’

200 men with advanced prostate cancer from three European cities will take part in the study with some of the men taking part in an organised six-month exercise programme. In London, Dr Van Hemelrijck will work on the study alongside Dr Simon Chowdhury, Consultant Medical Oncologist, and Mr Declan Cahill, Consultant Urologist, at Guy’s and St Thomas’ NHS Foundation Trust. 
Karen Sadler, Executive Director of World Cancer Research Fund said: ‘Thanks to the generosity of our supporters World Cancer Research Fund can fund innovative research into cancer prevention. Prostate cancer is one of the biggest killers of men and obesity one of the greatest challenges we face today. This important study could provide vital answers to help men with prostate cancer.’
World Cancer Research Fund is the UK charity in a network of cancer prevention organisations based in Europe, the Americas and Asia, led and unified by World Cancer Research Fund International. The cancer prevention research grant programme is managed by WCRF International.