Prostate Cancer and Obesity: Current Hypotheses and Challenges

Prostate cancer is the most common cancer diagnosed in males in the United States. Known prostate cancer risk factors include age, ethnicity, and genetic factors. There is some data suggesting that obesity is a risk factor for numerous aspects related to prostate cancer including prostate cancer development, biochemical recurrence, and prostate cancer mortality. Moreover, there may be potential therapeutic complications in the obese patient. Weight loss has also been shown to benefit the patient with prostate cancer. Finally, obesity may affect the microbiome and other molecular pathways such alterations in adipokine signaling, insulin and the insulin-like growth factor 1 pathway, and effects on the tumor microenvironment (e.g.: ectopic/periprostatic fat). The purpose of this review is to discuss the most current hypotheses on the relationship between obesity and prostate cancer across this broad spectrum of potential relationships.