Published on September 3, 2020
Prostate Cancer in African American Men
Approximately one in nine men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society.1 Prostate cancer disproportionately affects African American men compared to men of other ethnicities and/or races. Access to care, insurance coverage and other socioeconomic factors play a role in these health disparities. Without patient diversity in research such as clinical trials, it can be challenging to improve health outcomes. The good news is that a recent study aims to shed light on the complex issue of genomics and ethnicity in prostate cancer.
Better Medicine for Prostate Cancer in African American Men
Three research teams — from Boston University School of Medicine, UC San Francisco and Northwestern University — have identified genes that are more frequently altered in prostate tumors in African American men compared with other groups. The reason for this alteration isn’t yet clear, but hopefully, this study will help increase understanding.
Research on Prostate Cancer in Men of African Ancestry: The RESPOND Trial
The National Cancer Institute (NCI) and the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH) are supporting the RESPOND study to learn how gene variants affect outcomes of men with prostate cancer.2 This study, the first of its kind, has the potential to lead to precision therapies for prostate cancer.
RESPOND stands for Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor Markers and Social Stress. This large study will look at the underlying factors that put African American men at higher risk for prostate cancer. During the next five years, 10,000 African American men recently diagnosed with prostate cancer will be recruited.3 Participants will use a saliva collection kit to share their DNA information. This is anonymous and each person’s data will be randomly assigned an ID number.
What is Prostate-Specific Antigen (PSA) Testing?
Prostate cancer expert Dr. Maha Hussain, from the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, explained the significance of prostate-specific antigen (PSA) and the Gleason score in a Patient Power Ask The Expert interview.
“Prostate-specific antigen is a blood test, and it’s a product of prostate cells. A normal prostate will actually have what we call PSA, prostate-specific antigen, and because the cancer cells are a product of the normal prostate cells, they will, in the vast majority of times, retain the ability to make the PSA,” Dr. Hussain said.
Men with a PSA level between 4 and 10, the “borderline range,” have approximately a 1 in 4 chance of being diagnosed with prostate cancer.
What is Gleason Score Testing?
The medical team will also want to know what the Gleason score is, named after Dr. Donald Gleason, the pathologist who developed this scoring system in the 1960s to determine how aggressive the cancer is. The Gleason score is measured using a needle biopsy and the specimen is reviewed under the microscope. Cancer cells that look similar to healthy cells get a lower score, according to Cancer.Net.4
Other scores to be aware of:
- Gleason 6 or lower: The cells look similar to healthy cells. These patients may fall into the “watchful waiting” category and not need treatment right away. This is also called active surveillance.
- Gleason 7: The cells look somewhat similar to healthy cells.
- Gleason 8, 9, or 10: The cells look very different from healthy cells.
“The more it looks like the normal tissue, that’s the less aggressive, and the less it looks like the normal tissue, that makes it more aggressive, and because the prostate is a large organ, there could be the possibility of multiple areas that might have the cancer in it,” Dr. Hussain added.
Knowing your PSA and Gleason score is one way to help you make decisions about the next steps in your cancer journey.
Patient Power is working to help bring information and equity in cancer care for you and your loved ones.
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~Lauren Evoy Davis
1Prostate Cancer Statistics. American Cancer Society.
2African American Prostate Cancer Study. National Cancer Institute.
3RESPOND Study. Participate.
4Prostate Cancer: Stages and Grades. Cancer.Net.
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