Effect of race in prostate cancer survival is questioned

May 20, 2002

ORLANDO -- African-American patients with advanced prostate cancer survived slightly longer than white patients, according to a multi-institutional study led by Dana-Farber Cancer Institute researchers. The findings, which run counter to the conventional notion that African-Americans with the disease die sooner, were presented at the annual meeting of the American Society of Clinical Oncology in Orlando on May 19.

The data were derived from a pooled analysis of four randomized clinical trials in men with advanced prostate cancer that was no longer being held in check by hormone treatments. On average, African-Americans in the trials survived a median of 15 months while for whites the median survival was 14 months.

"This is evidence that African-Americans do just as well as whites when they're treated within the context of a clinical trial," said Timothy D. Gilligan, MD, a genitourinary oncologist at Dana-Farber. "This should discourage a pessimistic approach to prostate cancer in African-Americans in this setting."

The finding, said Gilligan, contradicts epidemiological evidence that has suggested that prostate cancer is more aggressive in African-Americans than in white men. Studies have shown that African-Americans typically are diagnosed with more advanced prostate cancer and that when treated, they have a higher mortality rate than whites do. But Gilligan said differences in treatment could explain the discrepancy.

The researchers, who include investigators from Dana-Farber, Duke University, the University of Maryland, the University of California at San Francisco, and the University of Chicago, pooled the outcomes of four trials of several different treatments for hormone-refractory prostate cancer. There were 844 white and 144 African-American men in the studies. Their average age was 71, and 90 percent had metastases to other organs.

Gilligan noted that it's not possible to generalize from this study to all prostate cancer patients: this was a select group of patients with the most advanced form of the disease. This slight survival advantage for African-Americans, however, should prompt further studies, said Gilligan, and it should help attract more African-Americans into prostate cancer trials.
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Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

Dana-Farber Cancer Institute

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