Prostate Cancer: Ethnic Differences, Screening, Treatment and Research

National Prostate Cancer Awareness Month in September is a way to help focus attention on a cancer that takes the lives of an estimated 27,000 fathers, husbands, brothers and sons in the United States each year.

UC Davis Cancer Center experts are available to discuss the following topics related to prostate cancer:

—Prostate cancer in African Americans
—Men have support groups, too
—Chemoprevention to slow or halt early prostate cancer
—Research to defeat androgen independence
—Robotic-assisted laparoscopic prostatectomy
—Making treatment choices

PROSTATE CANCER IN AFRICAN AMERICANS
African American men are more likely than white, Latino, Asian or American Indian men to develop prostate cancer. African Americans are also more likely to die of the disease.

Two research studies are under way at UC Davis Cancer Center to better understand the reasons for these disparities:

In one, researchers from UC Davis, Lawrence Livermore National Laboratory and UC San Francisco are studying the diets of African American men in Oakland, Calif., for factors that may explain their high risk of prostate cancer. Carcinogens present in meat cooked at high temperatures are chief suspects. James Felton, associate director for cancer control at UC Davis Cancer Center and a senior biomedical scientist at Lawrence Livermore, leads the study. Felton is internationally known for his research into dietary carcinogens and mutagens.

In the second study, investigators are analyzing blood samples from African American volunteers to look for genetic markers that may help predict prostate cancer risk. Leading this study is Ralph deVere White, professor of urology and director of the UC Davis Cancer Center.

MEN HAVE SUPPORT GROUPS, TOO
Women may have led the way with breast cancer support groups, but men with prostate cancer also find strength in numbers. The Mercy Health Care/UC Davis Prostate Cancer Support Group draws crowds of up to 100 men at its monthly meetings. The group brings together newly diagnosed men and long-term survivors, who share experiences and information about prostate cancer. Beverly Nicholson, an oncology clinical nurse specialist, is the founding facilitator of this 16-year-old support group, which meets from 1:30 to 3:30 p.m. on the third Thursday of each month. Meetings alternate between UC Davis Cancer Center and Mercy San Juan Medical Center.

CHEMOPREVENTION TO SLOW OR HALT THE GROWTH OF EARLY PROSTATE CANCER
An effective chemopreventive agent for prostate cancer would be an important development, giving men with early, localized disease an alternative to the three options they now have available: surgery, radiation and active surveillance or “watchful waiting.” In clinical trials at UC Davis Cancer Center, a soy-shiitake mushroom extract is showing promise as a way to slow or halt prostate cancer progression in these men. Ralph deVere White, professor of urology and director of the UC Davis Cancer Center, leads the research and can talk about its implications for prostate cancer prevention and treatment.

RESEARCH TO DEFEAT ANDROGEN INDEPENDENCE
Androgen independence occurs in the late stages of metastatic prostate cancer, when cancer cells develop the ability to live in the absence of male hormones. The disease can no longer be controlled with hormone therapy when this happens. Discovering how prostate cancer cells develop androgen independence – and how to prevent it – is a major focus of research at UC Davis Cancer Center. Hsing-Jien Kung, professor of biochemistry and molecular medicine and director of the Basic Science Program, can talk about progress in laboratory research aimed at unraveling this problem. Primo Lara, associate professor of hematology and oncology, can discuss clinical trials of experimental agents that may offer new hope for men with androgen-independent disease.

ROBOTIC-ASSISTED LAPAROSCOPIC PROSTATECTOMY
Now there’s a minimally invasive alternative to traditional prostatectomy. Robotic-assisted laparoscopic prostatectomy is performed via several small abdominal incisions, each about the size of a dime. Miniature robotic arms and a robotic laparoscope – essentially a tiny telescope – are introduced through the incisions. The surgeon operates the tools from a nearby console. Because the procedure involves smaller incisions, patients may be able to return to their normal activities more quickly than with standard prostatectomy. Christopher Evans, professor and chair of urology at UC Davis, can talk about the pros and cons of the procedure.

MAKING TREATMENT CHOICES
Active surveillance? Surgery? Radiation? For men with newly diagnosed prostate cancer, the treatment options can be daunting. Srinivasan Vijayakumar, professor and chair of radiation oncology at UC Davis Cancer Center, is the author of “An Oncologist’s View of Prostate Cancer: Understanding the Facts, Sorting through the Options.” He can talk about the pros and cons of surgical, radiation and medical therapies available to treat prostate cancer.