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Active surveillance may be safe for Black men with prostate cancer, study finds

Nov. 3 (UPI) — African-American men on active surveillance for low-risk prostate cancer are more likely than their White counterparts to experience disease progression and ultimately require treatment, a study published Tuesday by JAMA found.

However, men of both races included in the study were at the same risk for metastatic cancer — cancer that has spread to other organs — and death from the disease.

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The findings, researchers said, suggest that active surveillance is just as safe for African-American men as it is for White men.

In active surveillance, a person’s cancer is monitored closely, with prostate-specific antigen, or PSA, blood tests taken every six months as well as annual digital rectal exam and prostate biopsies, according to the American Cancer Society.

Based on the results of these more frequent assessments, more aggressive treatment may be recommended, the society said.

“Our research provides evidence that active surveillance is safe for African-American men,” study co-author Dr. Brent Rose said in a press release.

“This means more African-American men can avoid definitive treatment and the associated side effects of urinary incontinence, erectile dysfunction and bowel problems,” said Rose, assistant professor of radiation medicine and applied sciences at University of California San Diego School of Medicine.

Prostate cancer is the second-most common cancer among men, after skin cancer, according to the U.S. Centers for Disease Control and Prevention.

One in nine men will receive a prostate cancer diagnosis in their lifetime, but African-American men are nearly twice as likely to be diagnosed with the disease and more than twice as likely to die from it than men in other ethnic groups, the agency estimates.

The cancer is typically slow growing, and low-risk disease may not need to be treated immediately after diagnosis, if ever, and can instead be monitored under an active surveillance approach, Rose and his colleagues said.

However, because of the increased risk for prostate cancer and death from the disease among African-American men, active surveillance is used less frequently in this population, according to their researchers.

For this study, Rose and colleagues reviewed data on 8,726 men diagnosed with prostate cancer between 2001 and 2015.

About one in four of these study participants were African-American, the researchers said.

Just under 60% of African-American men included in the analysis experienced disease progression, compared to 48% of White men, the data showed.

In addition, 55% of African-American men in the study required treatment compared to just over 41% percent of White men.

Despite these differences, African-American and White men were diagnosed with metastatic prostate cancer at about the same rate — 1% versus 1.4% — and faced the same risk for death — about 1% — as one another.

“Physicians and patients should discuss active surveillance for African-American men with low-risk prostate cancer,” Rose said.

“However, due to the increased risk of progression, African-American men need to be carefully followed and promptly treated if their cancer progresses,” he said.

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