Prostate cancer and weight

Men who are overweight when they have locally advanced prostate cancer have almost double the risk of dying from the disease compared to men of normal weight, new research says.

The study, led by a team at Massachusetts General Hospital, is the first to find that obesity alone is associated with deaths in men whose tumors had grown beyond the prostate or spread to lymph nodes, according to the study in the journal Cancer.

"The prevalence of overweight and obesity continues to increase in the United States, so it's an issue that's perhaps more important than ever," author Dr. Matthew R. Smith said in an interview. "What we need to do from here are additional studies to understand the mechanisms by which overweight and obesity are associated with worse prostate cancer mortality."

In the current issue of the New England Journal of Medicine, Dr. Reshma Jagsi of the University of Michigan and Dr. Nancy J. Tarbell and Dr. Debra F. Weinstein, both of Harvard Medical School, write about why parents struggle so much during medical training. While federal law allows family leave, policies set by graduate programs and medical-specialty boards can make that unworkable if they require training to be completed within a fixed time frame.

"It is unrealistic and inappropriate to expect trainees to delay childbearing or to forgo spending critical time with their infants," they write. "We therefore need new solutions."

About 1 in 7 teenagers in Massachusetts and Vermont might have a substance abuse problem, according to screening questionnaires filled out during routine doctors' visits, a study has found. The adolescents' answers were more likely to indicate a problem when they were sick or injured than when they were having a checkup.

"Substance abuse screening should occur whenever the opportunity arises, not at well-child care visits only," wrote Dr. John R. Knight of Children's Hospital Boston, lead author of the study in this month's Archives of Pediatrics & Adolescent Medicine.

Researchers from Children's, Tufts-New England Medical Center, Cambridge Health Alliance, the University of Vermont and Fallon Clinic in Worcester questioned more than 2,000 12- to 18-year-old patients about drug and alcohol use and risky behavior. Overall, 14.8 percent of patients said yes to at least two of the six questions.

Positive screenings do not establish a diagnosis, the authors write, but they do require follow-up.

Researchers exploring connections between breast cancer and environmental exposures will use state funds to study chemicals found in households and the workplace.

The University of Massachusetts at Lowell, the Silent Spring Institute - a nonprofit that researches links between health and the environment - and the Massachusetts Breast Cancer Coalition will get $250,000.

"We're trying to lay the groundwork for innovative work in Massachusetts with new lines of research," said Richard Clapp, adjunct professor in UMass-Lowell's School of Health and Environment and professor of environmental health at Boston University School of Public Health.

MORE WHITE COAT NOTES At boston.com/yourlife/health/blog