Men – particularly Black men – who pile on the pounds as they get older put themselves at greater risk of prostate cancer, a new study shows. After following almost 84,000 middle-aged and older U.S. men for close to a decade, researchers discovered that White and Black men who had gained weight since the age of 21 had a higher risk of developing prostate cancer. But, compared with White men who gained fewer than 10 pounds, those who gained more had twice the risk of being diagnosed with advanced or aggressive prostate cancer. Among Black men, the risks began increasing after a 25-pound weight gain – though the link was seen only with early-stage and less-aggressive prostate tumors, and not advanced cancer. “These results do not warrant a change in the current public health messages about obesity,” Dr. Elizabeth A. Platz, another researcher on the work and an associate professor of epidemiology at Johns Hopkins University in Baltimore, said in a written statement. “Men of normal weight in all racial/ethnic groups should be encouraged to avoid weight gain,” she said, “and men who are overweight and obese should be encouraged to lose weight for good health in general.”

Researchers across the country are working painstakingly to determine why Black men develop prostate cancer at an earlier age and at twice the rate of any other group in America. Experts have long believed that there is a genetic link. For the past dozen years, Georgia Dunston, the founding director of Howard University’s National Human Genome Center, and Chiledum Ahaghotu have led the charge to figure out the racial component of the prostate cancer conundrum. They established the African-American Hereditary Prostate Cancer Study to study the family genes of Black men with prostate cancer. By tracking the health and genetic makeup of different generations, they aim to better understand why prostate cancer is so deadly among Black men and whether the disease is primarily inherited or caused by environmental or lifestyle factors. “We’re looking for those individuals who can give us an indicator of what are the genes that are associated with that underlying cancer,” said Dunston. “Because it’s not a difference in the gene – the difference is whether you’re born with it or it’s caused by changes that develop later in life.” More than a dozen research centers, including D.C.’s Howard University, have recruited Black men and their relatives – siblings, fathers, uncles, grandfathers, great-grandfathers from a total of 77 families – and recorded their medical history. With support from the National Institutes of Health and the National Human Genome Research Institute, AAHPC researchers have been sifting through family health records and looking at the participants’ genetic makeup, through blood samples, to see whether there are common genetic mutations or markers that are linked to the disease.

A new vaccine could mean a much brighter future for prostate cancer patients. The now-experimental treatment offers a novel approach to battling the disease and has shown promise in extending life. The Provenge cancer vaccine, manufactured by the Seattle-based Dendreon Corp., improved overall survival when compared to a dummy treatment in a study of 512 men with advanced disease. Dendreon says it will seek federal approval of the treatment later this year. Unlike traditional disease-preventing vaccines, Provenge is a therapeutic vaccine, which treats cancer by training the immune system to fight tumors. Provenge would be the first such treatment on the market if the government gives it the go-ahead. “This is an exciting result, demonstrating that harnessing a patient’s own immune system can successfully attack prostate cancer,” said Dr. Eric Small, cancer specialist at the University of California at San Francisco. “Now we have more confidence that the initial results we saw were real.”

The debate over the usefulness of prostate screenings rages on. Two more studies have reiterated longstanding concerns: While routine testing may save a few lives, it might not be worth the exorbitant price. A U.S. study of some 76,000 men has found that routine screening did not save lives, while a European study of 162,000 men concluded that there were about 7 fewer deaths per 10,000 men screened. The studies were released Wednesday by the New England Journal of Medicine in connection with a conference in Sweden. “The hope was there that there’d be a clear answer. Either that there was so little or no benefit that it clearly wasn’t worth the risks. Or that the benefit was so large, that it was,” said Dr. Michael Barry of Massachusetts General Hospital, who wrote an accompanying editorial in the journal. “What we’re left with is something in between — that the benefit is fairly small … and the risks are pretty big.” There are more than 186,000 cases of prostate cancer diagnosed among American men each year. Of those, about 28,660 will die of the disease. Blood tests measure prostate specific antigens (PSA) and whether there is a need for a biopsy to confirm the existence of a tumor. There is wide disagreement among medical experts about the best way to deal with the tumors.

We may not be that far away from a simple urine test to flag the seriousness of prostate cancer in men. As it stands now, men must undergo a battery of invasive diagnostic exams – including surgical biopsy – to confirm that he has prostate cancer. But even after the presence of the disease is identified, tests cannot effectively determine whether that cancer is rapidly growing or slowly growing, or how aggressive the treatment must be. Now, a study in the journal Nature reports, links specific molecules produced by the body to the aggressive form of the disease, suggesting that detecting these molecules could one day to lead to a reliable diagnosis and prognosis of prostate cancers. Scientists reviewed cell metabolism, using new scanning technology, and found certain identifying factors in blood, tissue and urine taken from patients with the deadliest forms of prostate cancer. “This is proof-of-principle that we can identify metabolites … that might be correlated with aggressive prostate cancer versus slower-growing prostate cancer,” Arul Chinnaiyan of University of Michigan Medical School, who led the study, said in a prepared statement. Prostate cancer is the most common cancer among men in the developed world. In the United States, where 186,000 Americans are diagnosed each year, only skin cancer is more common. But despite its prevalence, physicians have been frustrated by the lack of a fail-safe test. “One of the main issues with prostate cancer is trying to distinguish aggressive prostate cancer that goes on to metastasize from the slow-growing version of the disease, and what we end up doing as physicians is over-treating our patients because we can’t distinguish between them,” Chinnaiyan says.