For African American Men, Early Detection of Prostate Cancer is Crucial
Scientists have known for years that prostate cancer is worse in African American men. New research by urologist Edward Schaeffer, M.D., Ph.D., the R. Christian B. Evensen Professor helps explain why this happens, why black men should be extra vigilant in getting checked for prostate cancer and why, if cancer is found, they should seek curative treatment.
In a recent study, accepted for publication in the journal, Urology, Schaeffer looked at the outcomes of more than 17,000 men who underwent radical prostatectomy at Johns Hopkins. Of these men, 1,650 were African American, and many of them “were more likely to have higher-grade cancer at the time of surgery than the original biopsy had determined,” says Schaeffer. “They were more likely to have the cancer pushing outside of the pr ostate, as well. We also found that African American men were more likely to experience recurrence compared to Caucasian men with the same gr ade and stage of cancer.”
For example: Compared to Caucasian men with clinical stage T1c disease, African American men “had higher post-prostatectomy Gleason scores, greater cancer volume, and greater tumor volume in their serum PSA,” Schaeffer says. This finding is consistent with other research that suggests that in African American men, prostate cancer grows and progresses more rapidly than it does in other men, with four-fold higher rates of metastatic disease.
Although racial disparities in the incidence and outcomes of prostate cancer likely have many causes, “biologic differences seem to be key contributing factors,” Schaeffer notes. “These results suggest that African American men need heightened awareness about prostate cancer. Our African American patients need to know that they are likely to harbor more aggressive disease than the biopsy suggests, and that their prostate cancer may be more aggressive than prostate cancer in other men.”
“Our African American patients need to know that they are likely to harbor more aggressive disease than the biopsy suggests, and that their prostate cancer may be more aggressive than prostate cancer in other men.”
The take-home message, Schaeffer says, is that “African American men really need to know their stats. If there is a change in their PSA or exam, we recommend a biopsy. If the biopsy shows cancer, we advocate expedient aggressive treatment. With these actions, African American men with prostate cancer are still curable.” Co-contributors to this paper are Farzana Faisal, a Hopkins medical student and first author, and urology resident Deb Sundi, M.D.