LIMA — Black men in the U.S. are nearly 60% more likely to develop prostate cancer in their lifetimes and more than twice as likely to die from the disease than their white counterparts, a disparity often attributed to a combination of genetics, access to quality medical care and lack of insurance. But new research suggests access to care and other inequalities Black men in the U.S. encounter may be the primary driver of the differences in prostate cancer death rates.
“People have, for some reason, assumed that the reason Black men die more often of prostate cancer is because it’s genetic,” said Dr. Daniel Spratt, an associate professor and associate chair of research at the University of Michigan’s Department of Radiation Oncology.
Spratt and a team of University of Michigan researchers compared data from 300,000 prostate cancer patients, which found little to no difference — and sometimes even more positive outcomes — for Black men compared to non-Hispanic white men who had similar-stage prostate cancer, especially when those men had equal access to treatment.
But the study found Black men in the U.S. are more likely than white men to die of other causes like heart attacks, which Spratt said suggests equal access to quality healthcare would improve health outcomes for Black men regardless of a prostate cancer diagnosis.
The study did not examine why African-American men are more likely to be diagnosed with prostate cancer.
“So many of these conditions are higher in Black patients is because of these racial inequities that exist… and that’s why they’re more common,” Spratt said. “It has nothing to do with them being Black intrinsically; it has to do with how they’ve been treated in the U.S.”
The disparity persists in Allen County as well, where 210 out of every 100,000 Black men were diagnosed with prostate cancer from 2013 to 2017, compared to 112 out of every 100,000 white men in the same period, according to disease data from the Centers for Disease Control and Prevention.
Prostate cancer is the second-most common cancer in men. The American Cancer Society estimates one in nine men will be diagnosed with the disease in their lifetimes, while one in 41 men will die of the disease.
But because the disease progresses slowly, many physicians and urologists recommend active surveillance to manage low-grade prostate cancer before opting for surgery, radiation or other forms of treatment, which may carry their own side effects.
“(We) typically just watch and wait their cancer,” Dr. Michael Bishop, a radiation oncologist for Mercy Health-St. Rita’s Medical Center, said of low-risk patients with low-grade cancer.
Patients in active surveillance monitor their prostate-specific antigen, or PSA, scores and exams for changes, after which they may undergo radiation, chemotherapy, immunotherapy or surgery to remove the prostate, depending on the stage of cancer, among other forms of treatment.
“Any type of treatment comes with side effects and complications,” said Dr. Mwafa Turjman, an attending urologist for Lima Memorial Health System, “so if the survival is high and the cancer is very slow-growing, then the best quality of life for the patient (is active surveillance).”
Most men diagnosed with prostate cancer will die of other causes, Turjman said, but physicians will still actively monitor the disease’s progression in a patient to ensure the cancer doesn’t spread elsewhere or become more aggressive.
Bruce Bailey, 73, considers himself lucky to have been diagnosed with prostate cancer early, before the cancer moved to his bones. After noticing a change in his PSA scores, Bailey chose to undergo two-and-a-half weeks of radiation therapy at Mercy Health-St. Rita’s Medical Center. He says he’s had few complications since then and is relieved to have avoided lengthy treatment.
“It’s better to get it fixed early than wait until it escapes,” Bailey said.
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