MONDAY, January 3, 2022 (HealthDay News) – New analysis reveals racial paradox in prostate cancer care: While black men are often diagnosed later and have a more aggressive disease than whites, radiation therapy it seems to work better for them than for their white peers.
To reach that conclusion, the researchers reviewed seven studies involving more than 8,800 men with prostate cancer. Of these, 1,630 men were black. Blacks were younger than whites (68 versus 71) and had more advanced disease when enrolled in these trials. All men received standard or high-dose radiation therapy, and some underwent hormonal treatment for the disease.
Compared to whites, blacks were 12% less likely to experience a recurrence of prostate cancer and 28% less likely to have Cancer spread to other organs or die from prostate cancer after just over 10 years of follow-up.
Calling the findings “unexpected,” study author Dr. Amar Kishan said access to care could play a role in historically poor prostate cancer outcomes among black men.
“When blacks are prostate cancer gets the same standard of treatment and follows it in the same way as white patients, differences in survival at the very least disappear and may even change, ”said Kishan, vice president of clinical and translational research in the Radiation Oncology Department and head of the Department of Oncology. genitourinary oncology at the University of California, Los Angeles.
It is also possible that there is something in prostate cancer in some blacks that makes cancer cells more sensitive to the effects radiation therapy, Kishan noted. “The results would be at least the same if the main problem was barriers to care, but we have no explanation for the fact that the results are even better,” he pointed out.
Importantly, some of the trials included in the new review date back to the 1980s. “These tests did not necessarily use state-of-the-art radiation technology, which means the results could be even better with the newer technology,” Kishan said.
The study was published Dec. 29 in the journal JAMA network open.
“These data tell us that if blacks had access to fair care, we would not see inferior outcomes as we see today in blacks with prostate cancer compared to whites,” said Dr. Neeraj Agarwal, senior director of clinical innovation research at the Huntsman Cancer Institute. at the University of Utah in Salt Lake City.
“The biggest question is how to ensure that blacks have access to equal access to health care,” said Agarwal, who co-authored an editorial with the new study.
“Blacks with prostate cancer receive less than optimal therapy,” said Dr. Otis Brawley, a professor of oncology at Johns Hopkins University School of Medicine in Baltimore.
It’s not about skin color or race, said Brawley, who has nothing to do with the new study. “Blacks are not biologically different from whites,” he said. “Race is a socioeconomic category.”
Many blacks live in poorer neighborhoods and have less access to high-quality care, Brawley explained.
Another cancer expert not included in the study said more research is needed to interpret the findings.
“We have seen that the effect of race / ethnicity on treatment outcome can be greatly reversed if patients are diagnosed early and treated appropriately,” said Dr. Madhur Garg, clinical director of radiation oncology at Montefiore Health System in New York City. “Enrollment in clinical trials should be encouraged to learn more about the biology of prostate cancer and whether certain treatments will be more effective than others based on race and ethnicity.”
The American Cancer Society provides more information on diagnosis and treatment of prostate cancer.
SOURCES: Amar Kishan, MD, Associate Professor and Vice President, Clinical and Translational Research, Department of Radiation Oncology, Chief, Genitourinary Oncology Service, University of California, Los Angeles; Neeraj Agarwal, MD, Senior Director, Clinical Research Innovation, Huntsman Cancer Institute, University of Utah, Salt Lake City;. Otis Brawley, MD, Professor of Oncology, Johns Hopkins University School of Medicine, Baltimore; Madhur Garg, MD, Clinical Director, Radiation Oncology, Montefiore Health System, New York City; JAMA network opened, December 29, 2021