African American Men and Prostate Cancer

During National Men’s Health Week, iTriage and its partner Cutting For A Cure explore health issues affecting African American men. Today, we look at how this population is affected by prostate cancer.

It’s well documented that African American men suffer from prostate cancer at a higher rate than men of other ethnicities. The National Cancer Institute provides incidence numbers of 277 per 100,000 for African American men versus 168 per 100,000 for men of European descent, indicating almost double the occurrence. Further, the mortality associated with a diagnosis of prostate cancer is almost tripled for African American males as compared to white males. The African American Hereditary Prostate Cancer Study Network and other research indicate that there is a significant genetic component to this phenomenon. Studying almost 500 men within families of men who had developed the disease, researchers were able to identify regions of the human genome that increase the risk of developed prostate cancer when altered or mutated.

Risk Factors for Prostate Cancer

According to the National Cancer Institute, “family history is the most significant risk factor for prostate cancer among all men, including African Americans.” Other risk factors include age, race, and whether an individual lives north or south of 40-degree latitude.

• Age has long been associated with an increased rate of prostate cancer, ranging in incidence from 1:10,000 for men younger than age 40 to as common as 1:15 for men in their 60s.
• Race contributes to incidence, with African Americans demonstrating the highest occurrence, followed by white men and then Asians.
• Lower vitamin D levels are related to higher prostate mortality levels, so the latitude of where one lives is thought to influence prostate cancer rates.

Risk Factors for Aggressive Prostate Cancer

Prostate cancer is typically classified as aggressive or slow-growing, with the classification and the age of the man affected often determining treatment plans. Risk factors for aggressive prostate cancer include being of African American descent, and family history. Additional factors that are associated with higher rates of aggressive cancers include smoking, lack of adequate dietary green vegetables, obesity, height, lack of exercise and a high calcium intake.

Early Detection and Screening

Prostate screening has been controversial in the medical community, who has recently questioned the cost effectiveness, quality, and safety of the procedure. Clinicians have come to rely on prostate examinations and the prostate-specific antigen (PSA) laboratory tests to catch the disease in its early stages in men 50 and over as part of a regular check-up. An above normal PSA level can signal prostate cancer, but could also rise for less serious reasons such as an enlarged prostate, a prostate infection, after having sex or riding a bicycle.

The United States Preventative Services Task Force (USPSTF) made a final recommendation recently against using the PSA test screening for healthy men, asserting that there is “moderate or high certainty that the service has no benefit or that the harms outweigh the benefits.” The USPSTF says there is little, if any, evidence that PSA testing saves lives and that too many men instead suffer from impotence, incontinence, heart attacks, and occasionally death from treatment of tiny tumors that would never kill them. The Prostate Cancer Foundation and the American Urological Association are refuting the USPSTF recommendations and the recent clinical studies still citing the health benefits to obtaining the tests.  Patients should still communicate with their healthcare providers to discuss the pros and cons of obtaining a PSA blood level, considering personal risk factors for Prostate Cancer.

Physical Symptoms

Unfortunately, by the time symptoms of prostate cancer become apparent, the condition is considered advanced or has metastasized beyond the prostate gland. Physical symptoms of prostate cancer may also be caused by other benign urological conditions. The malignancy has presented in patients by causing a slow or weak urinary stream, frequent urination, blood in the urine, impotence or low back and hip pain.

Prostate Cancer Treatment Options

Depending upon a patient’s age, health, the stage of the prostate cancer and the chance of treatment success, he and his doctors may chose from any combination of treatment options, including:

• Expectant or active surveillance: According to the American Cancer Society, surveillance might be an option “if you are older or have other serious health problems and your cancer is slow-growing (low-grade), you might find it helpful to think of prostate cancer as a chronic disease” and treat side effects as they arise.
• Surgery: In addition to the traditional surgical treatment—radical prostatectomy—there are now additional surgical options for patients to consider, such as laparoscopic prostatectomy and robotic-assisted prostatectomy.
• Radiation Therapy: In addition to traditional radiation therapy, newer types of radiation therapy include conformal radiation therapy, intensity-modulated radiation therapy and proton therapy, which targets cancer cells while causing fewer side effects.
• Chemotherapy: The options for chemotherapy treatment are as varied as the results of the latest studies, the type of cancer presented and what combinations are trusted most by a patient’s oncologist.
• Hormone therapy: Hormone therapy is frequently used for slow-growing, nonaggressive cancers.

Prostate Cancer Prevention

Research in the field of prostate cancer prevention can be both prostate-specific and general, in promoting overall health. Prevention interventions related to prostate cancer risk factors include:

• Maintain a healthy weight
• Minimize your dietary fat
• Maintain a calcium intake of less than 1,500 mg per day
• Try to eat or increase your intake of cooked tomatoes infused with olive oil, broccoli, cauliflower, soy, and green tea

Identification of risk factors associated with prostate cancer is a positive step in the prevention of this disease, especially if you are African American. Ultimately, the first success is an early identification of prostate cancer, allowing for earlier treatment and a greater variety of treatment options.

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For more information about iTriage, visit www.iTriageHealth.com.

For more information about Cutting For A Cure, visit www.Cutting4ACure.com.