Obesity, but not diabetes, is associated with greater prostate cancer mortality among men receiving combined modality treatment for local advanced disease, data show.

A study conducted by Matthew R. Smith, MD, PhD, of Massachusetts General Hospital in Boston, analyzed data from 1,554 men who participated in a large randomized clinical trial. The men were treated with radiation therapy and short-term or long-term goserelin for locally advanced prostate cancer. Of 765 deaths, 210 (27%) were attributed to prostate cancer.

After controlling for other covariates, the presence of diabetes was associated with a twofold greater risk of death from all causes and death from causes other than prostate cancer, researchers reported in the Journal of Clinical Oncology (2008;26:4333-4339). Diabetes did not affect prostate cancer mortality. Obesity, however, increased the risk of prostate cancer death twofold.

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The investigators said their observations suggest that the association between obesity and increased prostate cancer mortality is mediated by a mechanism or mechanisms other than the characteristic metabolic alterations of diabetes.