Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Prostate cancer: Postdiagnosis weight gain linked to greater mortality risk

Key clinical point: Postdiagnosis weight gain among survivors of nonmetastatic prostate cancer may be associated with a higher risk for all-cause mortality and prostate cancer-specific mortality (PCSM).

Major finding: Postdiagnosis weight gain vs. stable weight was associated with a higher risk for PCSM (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.21-2.25) and all-cause mortality (HR, 1.27; 95% CI, 1.12-1.45).

Study details: Participants from the Cancer Prevention Study II Nutrition Cohort diagnosed with nonmetastatic prostate cancer (n = 11,788) were followed-up.

Disclosures: The study was supported by the American Cancer Society and the Laney Graduate School at Emory University. Flanders WD reported ties with Epidemiologic Research & Methods. The other authors declared no conflicts of interest.


Postdiagnosis of prostate cancer is a stressful time for patients. This may be a time for patients to be motivated to make lifestyle changes to improve quality and quantity of life. Identification of modifiable risk factors may help patients identify an area where they can exert some semblance of control of their situation. Some, but not all, previous studies suggest that obesity in the post-diagnosis setting may be associated with an increased prostate cancer-specific mortality (PCSM). Troeschel et al. evaluated whether there may be an association between postdiagnosis body mass index and weight change and PCSM, cardiovascular disease-related mortality (CVDM), and all-cause mortality in a large cohort. Postdiagnosis obesity was associated with a statistically significant higher CVDM and all-cause mortality, but a nonsignificant higher PCSM. This was an observational study, so causation was not able to be determined, suggesting further evaluation is needed.

Mark Klein, MD


Troeschel AN et al. J Clin Oncol. 2020 Apr 6. doi: 10.1200/JCO.19.02185.