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Black Men and Prostate Cancer with Edward Schaeffer, MD, PhD

Black men are more likely to get prostate cancer and more than twice as likely to die from the disease than other men. Edward Schaeffer, MD, PhD, has developed a research team to better understand this problem. In this show he talks about his latest discoveries, which are paving the way to precision medicine for aggressive prostate cancer. Schaeffer is the chair of the Department of Urology at Northwestern and a Northwestern Medicine urologist with a specialized practice in prostate cancer.

 

"In the last couple of years (we've) begun to explore how the tumors may be different in terms of their genes and how their genes are activated and how that may play a role in cancer aggressiveness for men of African ancestry."

— Edward Schaeffer, MD, PhD

Episode Notes

Edward Schaeffer, MD, PhD, explains the current state of prostate cancer in America, including typical screening tools, treatments and outcomes. Overall, the number of deaths from prostate cancer has decreased and plateaued over the last decade. Despite recent advances, Schaeffer says, there is still a 1.8-fold increased risk of being diagnosed with prostate cancer for Black men compared to white men.

After seeing firsthand how Black patients suffered disproportionately from the disease when he began researching prostate cancer 15 years ago, Schaeffer developed a research program to investigate this disparity on a molecular level.

Other topics covered:

  • The number of new prostate cancer diagnoses has declined overall due to refinements in how we test and screen for prostate cancer, according to Schaeffer. He also says the number of deaths has decreased as a record number of FDA-approved compounds to help treat and control the disease have come on the market. 
  • Access to care is a major issue for many Black men and social determinants of health always have been and remain important, Schaeffer emphasizes, but his team has also observed how specific genes with mutations or alterations in men of African ancestry are associated with more aggressive disease progression. 
  • A recent glimmer of hope from his lab was featured in Nature Communications. The paper reported on a FDA-approved immunotherapy for men with advanced metastatic prostate cancer: Black men had better responses to the immunotherapy than white men. On average, Schaeffer found more plasma cells from tumors in Black men, and in all men with elevated plasma cell levels, there was improved cancer-free survival following surgery.
  • Schaeffer's ultimate goal is to identify unique vulnerabilities amongst different tumors that will enable his team to do precision-medicine-based trials to address an individual cancer's vulnerability. "In many ways, if we can really understand that for all men, then we don't really see their tumors as tumors from a Black man or tumors from a white man," he says. "It is more like, 'Well this particular tumor is vulnerable to treatment X and this particular tumor is vulnerable treatment Y based on the genomics of the individual tumor.'"

Additional Reading: 

  • Read a 2020 study published in the journal Clinical Cancer Research in which Schaeffer and colleagues showed that a mutation in a gene in Black men with aggressive prostate cancer was associated with poorer patient outcomes.

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Recorded on March 10, 2021.