“The studies are a bit controversial, and other big-data studies of large databases across Medicare and the country clearly show that African-American men are still more severely affected by prostate cancer.
There are some questions why that is—possibly the biology of the disease—where prostate cancer actually starts. In African-American men, it often occurs in the apex of the prostate. That’s a tougher area to biopsy. We may miss cancers more often than in other races. So I take new studies that show active surveillance is a more likely scenario for African-Americans with a grain of salt.
Until we have better information on genetic makeup that correlates with the biology of the disease, we still have to be vigilant in our approach to prostate cancer in African-American men.
Many studies still stand with the fact that African-American men are also more likely than not to have more aggressive disease. Certainly some patients have a benign course, but we have to monitor these patients very closely.
As for the treatment studies, we know certain men respond to chemotherapy, others to radiation. So it makes sense that some subtypes of population, whether African-American or other races, are going to respond to specific treatments better than others. But until we have a good genetic profile of which cancers respond better, we don’t have much choice except to continue doing what we’re doing.”
Michael Palese, MD / New York
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