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Study claims having BPH may actually decrease odds of getting PCa. Huh?

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Posted 9/19/2021 5:15 PM (GMT 0)
Certainly seems like a counterintuitive claim, doesn't it?

The first thing I did after chancing upon the first-linked article below, the article making this claim, and dated this past September 15, so it's recent, was to check into the credibility of its source. Its source is the journal "The Prostate," which is, from what I can tell, a responsible medical publication.

From this article:

"BPH might significantly reduce a man’s chances of developing prostate cancer, according to a press release issued by Beaumont Health, Michigan’s largest health care system."

"Scientists measured the thickness of the central and outside part of the prostate gland to assess the possibility of disease. Results showed that an increase in the size thickness of the gland was linked with a decreased presence of prostate cancer.

“Our research showed patients with an enlarged prostate appear to have lower odds of significant prostate cancer.”

"The mechanical pressure of an enlarged prostate gland may actually inhibit cancer growth. That raises the possibility that common drugs used to treat BPH by shrinking the prostate may actually increase prostate cancer risk." (Boldface mine)

"... commonly prescribed drugs used to treat BPH may result in higher-grade prostate cancer.”

https://www.cancerhealth.com/article/enlarged-prostate-may-actually-reduce-prostate-cancer-risk

Here is the actual journal article. Unfortunately, full text is not available without paying for it, but there is free summary data provided that details how study was done. And the summary data does make one especially interesting statement:

"For every one cc increase in CG (central gland) volume, there was an approximately 3% decrease in odds of ≥GG2 disease."

https://onlinelibrary.wiley.com/doi/full/10.1002/pros.24207

Clearly, this going to be very controversial. (Or is this something already well known, and I have just missed it?)

But it also just seems like something as basic a correlation as this, between BPH and PCa incidence, would have already been noticed before now. Or maybe not.

I guess we'll just have to stay tuned to see where this one goes, but it sure seems like it's going to shake things up if it's true.

(BTW, if this does turn out to be true, I just had a really crazy thought. What if, instead of being a problem, BPH is actually a natural, evolutionary means the body employs to avoid PCa, and all our efforts to defeat BPH have actually been working toward getting PCa???. That's probably completely false, but with articles like the above coming out, I have to wonder!)
Posted 9/19/2021 5:51 PM (GMT 0)
Evolutionary trends would only happen if there is a significant increase in survival before reproduction. Since BPH and PCa primarily affect men well after the majority of their child generating years it is unlikely that this effect would be the result of natural selection.

My first thought on reading your post (I have not looked at the paper at all) is that men with BPH are seeing urologists and so are screened for PCa more than men w/o BPH, and the latter may develop higher grade PCa before being detected.
Posted 9/19/2021 6:50 PM (GMT 0)
Vynbal -

Your observation that the real correlation going on here is one between appearance of BPH symptons and then going to the doctor, resulting in earlier PCa treatment than otherwise would have been the case, deserves consideration.

But I'm still concerned about the statement made in the article summary data:

"For every one cc increase in CG (central gland) volume, there was an approximately 3% decrease in odds of ≥GG2 disease."

That certainly sounds like a conclusion drawn from analyzing data. (I can almost see the graph in my mind, cc-increase-in-prostate-size versus decrease-in-odds-of-disease, making a nice, straight line). That suggesting that there is something biological going on, independent of whether one visits the doctor for BPH symptoms or not.

I'm pretty sure that article is going to generate letters to the editor at the very least, and after the experts have debated the matter, and settled it, then we'll be seeing what the facts are here.

As for my "evolutionary" BPH idea, yeah, that was pretty off-the-wall, so let's just junk that one!

Thank you for your observations.
Posted 9/19/2021 8:06 PM (GMT 0)
That men with BPH have slightly reduced odds of getting PCa have been known for some time. Unfortunately, guys like me, with a long history of BPH, still get PCa.

Djin
Posted 9/21/2021 2:33 PM (GMT 0)

DjinTonic said...
That men with BPH have slightly reduced odds of getting PCa have been known for some time. Unfortunately, guys like me, with a long history of BPH, still get PCa.

Djin

Ditto......

Given lots of time and curiosity, you can discover contradictory studies about anything, usually confusing yourself no end. ;-)
Posted 9/21/2021 6:25 PM (GMT 0)

garyi said...


Given lots of time and curiosity, you can discover contradictory studies about anything, usually confusing yourself no end. ;-)

Hi Gary. However, in this case the new study confirms the earlier findings about BPH and decreased PCa risk. However, contrary to the conjecture from the article above that prostate-shrinking drugs might *increase* the changes of PCa, studies have shown that drugs like finasteride actually *reduce* the changes of low-grade PCa by about 25%.

But yes, there can be contradictory studies at time, which is why studies need to be examined, analyzed, compared, and repeated.

There is also the "obesity paradox" -- there is a statistically slightly lower chance of obese men encountering PCa than men with normal weight (not that this unexplained correlation is an excuse to overeat!).

Djin
Posted 9/22/2021 12:50 PM (GMT 0)
Since I suffered with prostatitis and later a huge prostate for many years, I wish it had helped me! In fact, maybe the only positive side effect of my surgery was getting rid of the problems my prostate ha been causing me for over 30 years. I think I was 1st treated for prostatitis about 1980 or 81. I was never actually treated for BPH, but it turns out mine was pretty huge, 106 gm. Apparently was of no benefit as far as my PC. Or anything else.

Just goes to show that having the odds in your favor still guarantees nothing. Plus, the observation that men with BPH would be seeing Urologists and getting diagnosed earlier has some merit. Although, this would only seem an advantage regarding being diagnosed BEFORE the horse is out of the barn. As far as total # of diagnosed, it seems it might actually increase the odds of being diagnosed with early PC? If so, that would only strengthen the relationship between BPH and lower cancer risk. Weird.

Post Edited (BillyBob@388) : 9/22/2021 6:58:37 AM (GMT-6)

Posted 9/22/2021 1:19 PM (GMT 0)

DjinTonic said...
........................
There is also the "obesity paradox" -- there is a statistically slightly lower chance of obese men encountering PCa than men with normal weight (not that this unexplained correlation is an excuse to overeat!).

Djin


............................................

Same with diabetes, which worsens the odds for every other cancer, as well as the odds for advanced PC or mortality fro it. But not a diagnoses with PC, diabetes(and obesity) apparently lowers those odds.

My pet theory on that is that, no, diabetes does not lower your odds of PC or any other cancer, rather the opposite. But what diabetes does do is get men treated for diabetes years or decades before they would normally become detectable for that PC that has been growing inside of them for many years. And what treatment is the very first at least attempted? Diet, which at least might lower the mount of insulin being produced to del with the sugar in the blood. And what normally comes next? Metformin. (which some think helps with PC and other cancers) And what does that do? Improves insulin sensitivity and thus lowers the amount of insulin the body must produce to deal with blood sugar, and which can also stimulate growth of all known cancers. Many diabetics have both dietary improvements AND metformin working in their favor to lower both blood sugar AND the growth factor blood insulin.

Hence, my theory is(might be wrong) is that it is NOT the diabetes or obesity that causes a decrease in diagnoses of (low risk) PC(and no other cancer). It is the treatment of both with approaches which will lower both blood sugar and insulin, during all of those years when our slow growing PCs would have been growing from just a few cells. But, apparently it is the insulin which is the biggest player for PC. I recall one study which those with the highest insulin levels had 3 times worse prognosis for PC ( maybe for advanced PC? can't remember) and those with the highest blood insulin AND highest waist to hip ratios(or whatever the spare tire is called) had 8 times worse.

Post Edited (BillyBob@388) : 9/22/2021 7:22:42 AM (GMT-6)

Posted 9/22/2021 1:21 PM (GMT 0)

BillyBob@388 said...


Just goes to show that having the odds in your favor still guarantees nothing. Plus, the observation that men with BPH would be seeing Urologists and getting diagnosed earlier has some merit. Although, this would only seem an advantage regarding being diagnosed BEFORE the horse is out of the barn. As far as total # of diagnosed, it seems it might actually increase the odds of being diagnosed with early PC? If so, that would only strengthen the relationship between BPH and lower cancer risk. Weird.

Regarding the odds you are totally correct. Knowing, for example that your nodule has, say, "only" a 48% chance of being PCa rather than 50% is of no practical value. The slightly skewed stats for PCa risk with BPH and with obesity are of scientific importance-- knowing why might shed light on the mechanisms at work.

Regarding early BPH and early PCa diagnosis, I think that fits my case perfectly. Even though my G9 PCa turned out to have a low-risk estimate (by the Decipher test) for metastasizing, I credit the fact that I was seeing a uro regularly (twice a year after my TURP) and getting periodic biopsies for my early diagnosis and treatment (5% prostate involvement and prostate-confined). This may turn out to have prolonged my life, and saved me from RT and two years of ADT after my surgery (time will tell about any salvage therapy).

Djin
Posted 9/22/2021 1:25 PM (GMT 0)
Djin, I think you are right! Your BPH, by driving you to a URO, may have greatly improved your odds in the fight against the PC beast.
Posted 9/23/2021 10:01 PM (GMT 0)
I am soooo very confused ;-)
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