Black men with prostate cancer may respond better to radiation therapy than White men, according to a new study. Photo by Joshua Woroniecki/Pixabay
Dec. 29 (UPI) — Black men with prostate cancer appear to respond better than White men to radiation therapy for the disease, an analysis published Wednesday by JAMA Network Open found.
Based on data from seven clinical trials, Black men with the disease who are treated with radiation therapy were 12% less likely to experience cancer recurrence and 28% less likely to their tumors metastasize, or spread, to distant organs compared with White men, the data showed.
In addition, Black men who received radiation therapy were 28% less likely to die from prostate cancer than White men given the treatment.
This is despite the fact the Black men seemed to have more aggressive disease when they enrolled in clinical trials of radiation, according to the researchers.
“These results provide high-level evidence challenging the common belief that Black men who are diagnosed with prostate cancer will necessarily have a worse prognosis than White men,” analysis co-author Dr. Amar Kishan said in a press release.
“This is especially important because an unfounded belief can inadvertently contribute to ‘cancer injustice,’ leading to the use of more aggressive treatments than might be necessary,” said Kishan, chief of the Genitourinary Oncology Service at the David Geffen School of Medicine at UCLA.
These aggressive treatments can, in turn, potentially lower quality of life, he said.
About one in eight men in the United States will be diagnosed with prostate cancer, or a tumor in the gland of the same name, and there are nearly 250,000 new cases of the disease annually, with Black men considered to be at increased risk, the American Cancer Society estimates.
Less than 3% of those diagnosed with the disease will die from it, but the risk for death is twice as high among Black men than for those in other racial and ethnic groups, according to the society.
Radiation therapy, which uses high-energy rays or particles to kill cancer cells, is often the first treatment used in men with prostate cancer, as it preserves function in the gland, which plays a key role in urinary and sexual health, it says.
For this analysis, Kishan and his colleagues looked at individual patient data from seven clinical trials of radiation therapy that collectively enrolled 8,814 participants.
All patients in the trials received either standard or high-dose radiation therapy, and some patients also underwent short- or long-term androgen deprivation therapy, a hormone-based treatment for the disease, the researchers said.
Of all participants in the seven trials, 1,630 men self-identified as Black and 7,184 as White.
Most of the Black men in the studies were in their late 60s, as opposed to early 70s for the White participants, and most had been diagnosed with high-risk disease, meaning it was likely to spread.
Still, Black men in the trials had lower rates of disease recurrence, tumor metastasis and death compared with White men, the data showed.
When adjustments were made for age and other factors, Black men still had better outcomes following treatment than White men, the researchers said.
“This information will help us identify potential drivers and mitigators of disparities in prostate cancer care,” co-author Dr. Ting Martin Ma said in a press release.
However, because Black men tend to be less willing to entertain the idea of participating in clinical trials, due to “medical mistrust,” the equity in access to care and receipt of treatment may not be representative of what normally occurs, added Ma, resident physician at UCLA.