According to a new study, African American men may not benefit from watchful waiting after being diagnosed with low-grade prostate cancer. In the study, researchers analyzed "pathologic," rather than "biopsy," Gleason scores of men with low-grade prostate cancer that had all or part of their prostate removed via surgery.
They found that African American men were more likely to experience disease progression and poorer outcomes compared with Caucasian men. Specifically, 79% of African American men had disease control at 7 years, while 90% of Caucasian men had 7-year disease control, a difference of 11%.
Kosj Yamoah, MD, PhD, Chief Resident of the Department of Radiation Oncology at Thomas Jefferson University in Philadelphia, Pennsylvania, says their study suggests that African American men with low-grade prostate cancer should be treated more aggressively than Caucasian men. When a patient is diagnosed with low-grade disease, many clinicians and patients opt for watchful waiting rather than treatment; however, this option may not be best for African Americans, whose cancer is more likely to develop aggressively sooner than Caucasian men.
Dr. Yamoah and his team are also researching how to identify which African American men with low-grade disease have an increased risk for disease progression.
There is an active controversy among oncologists about when to treat prostate cancer patients, with some suggesting that the word “cancer” be removed from the description of low grade disease, in order to prevent over-treatment. However a new study shows that these guidelines may not be appropriate for everyone, especially African American men.
“We know that African American men have more aggressive prostate cancer than Caucasian men,” says Kosj Yamoah M.D., Ph.D., Chief Resident, Department of Radiation Oncology at Thomas Jefferson University. “Our study shows that African American men who are diagnosed with a low-grade cancer at first – the cancers that are sometimes watched rather than treated – are more likely to develop aggressive disease sooner than Caucasian men.”