In the United States, prostate cancer deaths have been reduced by over 50 percent in the past 25 years. But there is a catch. In the United States, men of African descent are more likely to develop prostate cancer than any other population, and are nearly 2.4 times more likely to die from it.

These cruel statistics oversimplify the complex reality for men of African descent. Across the board, African-American prostate cancer patients present with higher-grade disease are younger, often have less access to quality care and have higher PSA levels and greater incidence of metastatic disease.

Nurture vs. nature

These glaring disparities have been attributed to a multifaceted suite of cultural and biological factors. In an effort to decipher these complexities, the Prostate Cancer Foundation (PCF) launched the African-American Research Initiative in 2013. The following year, PCF-funded researchers reported that self-identified race or ethnicity is correlated with behavior that affects health care seeking behavior and other environmental factors. Tied to lifestyle and socio-economic status, obesity is a dominant factor.

"African-American prostate cancer patients are younger, often have less access to quality care and have higher PSA levels and greater incidence of metastatic disease."

Obesity appears to have a disproportionate effect on promoting prostate cancer—particularly at an earlier age—in men of African descent, compared with Caucasian men. Extensive research suggests that weight loss in obese men of African descent may help to normalize their disproportionate burden of aggressive disease.

Locating biomarkers

The PCF African-American Research Initiative is concentrating on cancer-causing genes called “biomarkers” that are linked with elevated risk of earlier age and aggressive disease. PCF researchers determined that African-American men are more likely than European men to harbor at least six biomarkers like SPINK1 and ERG and ETS. These genetic signatures are associated with potentially lethal prostate cancers that require earlier detection and action, and far closer monitoring.

Another team of over 30 PCF researchers from the Cleveland Clinic and Thomas Jefferson University discovered one of the mechanisms responsible for the treatment-resistant prostate cancer that is more common among patients of African descent. They found that some prostate cancers are more resistant to radiation therapy and chemotherapy than others. These radiation-resistant tumors express a small group of proteins, known as the IRDS response, which enables them to survive better during treatment. We need research in new medicines to cure IRDS hyperactive tumors, which are more frequent in African-American men.

Martin Luther King, Jr. said, “Life’s most persistent and urgent question is, ‘What are you doing for others?’” We need to persistently and urgently accelerate research that solves the undue burden of more aggressive prostate cancer among African-American men so we can apply that knowledge to ending all prostate cancer deaths for all humankind.