DALLAS (Special to the NNPA from the Dallas Examiner) - Theories continue to abound surrounding the deaths of Rufus and Lynn Flint Shaw, a couple with New Orleans roots, who were found shot to death in their Oak Cliff home March 10.
The case has raised the painful issue about suicide, particularly in the Black community.
The husband and wife team were victims of an apparent murder-suicide pact, where it's speculated that Rufus, 56, shot Lynn, 53, then took his own life.
In the book, Lay My Burden Down, noted Harvard Medical School psychiatrist Dr. Alvin Poussaint and writer Amy Alexander analyze how much of the Black community - determined to be victors, not victims - strive to downplay issues of mental illness, depression and resulting suicides within the culture.
"It is very much a misperception that Black people don't commit suicide and that comes in part from a need, the very real and legitimate need, for Black people, for many years to be very strong," Alexander is quoted as saying in a book review by HealthyPlace.com. Alexander had an older brother who committed suicide.
"They [Blacks] see mental disorder and depression as a sign of personal weakness or moral failure," said Poussaint, who considered his brother's slow and painful death from heroin abuse as a precipitated form of suicide.
DeSoto pastor of Lifeway Church, Dr. Karen Hollie discusses the stereotype regarding suicide among Blacks as well as the way Blacks deal with pain.
"There are some stigmas involved. We particularly don't engage in that kind of thing," said Dr. Hollie, who was a practicing psychological therapist and counselor for 25 years, before leaving her practice two years ago, now applying her training as pastor of Johnson Chapel Community Church, also in DeSoto before going on to Lifeway.
"We have a different set of coping skills that we employ for a lot of things," Hollie said. "The helplessness and the hopelessness is not the same. We seem to have some other avenues that we employ and some just say we have some economic implications for it that makes a difference. We generally just don't fall into that."
According to an article published in the Journal of Black Psycology, Felicia Griffin-Fennell and Michelle Williams attribute the reluctance of Blacks and women to kill themselves to their religious convictions, turning to God for help in times of distress and believing that He has full authority over life and death. Many site the fear of eternal damnation as a reason for their reluctance to attempt or complete suicide.
Statistics from the Centers for Disease Control suggests that from 1988 to 1992, white males were 12 times more likely to kill themselves than Black males and white women more than 15 times more likely than Black women. Authors of Racial Differences in Hopelessness as a Risk Factor for a Nearly Lethal Suicide Attempt, in the Aug. 1, 2006 issue of the Journal of Black Psychology, say that suicide is about hopelessness, adding that a better understanding of racial differences in hopelessness and suicide may result in more effective interventions to slow the increasing Black American suicide rate.
According to a 2003 report by the National Institute of Health, "On an average day in the United States, one African American dies by suicide every 4.5 hours."
Poussaint stated the birth, growth and adopting of blues music as an example of how many Blacks just learned to deal with their oppressing and depressing times.
Still suffering from the vestiges of slavery and still targets of institutionalized racism and discrimination today, with health and economic disparities in their disfavor in almost all societal categories, Blacks are the first group of people who need to seek help for possible mental illness and depression, yet the last ones to get it. That is compounded by the fact that Blacks still make up only about 2.3 percent of all psychiatrists in the industry, making it more difficult to receive culturally sensitive consultation and treatment.
According to the Violence Policy Center, through their review of the report American Roulette: Murder-Suicide in the United States, Florida, California and Texas led the nation in murder-suicides. More than 10 murder-suicides, almost all by gun, occur each week in the United States. The Shaws' case appears to be consistent with the study.
The study stated that 90.4 percent of the offenders were male. According to another study, The Epidemiology of Murder-Suicide in Journal of the American Medical Association, which reviewed only couples, more than 90 percent of these acts were perpetrated by men. Additionally, according to the VPC report, when women are the perpetrators, the victims tend to be their children, not their intimate partner. The men, according to the report, tend to be older than their victims. VPC also reports that they usually occur in the home, and most frequently involve intimate partners, where the male is usually older.
Additionally, according to a study by the American Journal of Psychiatry, the over-whelming majority of male perpetrators of murder-suicide were depressed. According to a close friend, in his last days, Rufus rarely left the house and became increasingly agitated - both signs of depression.
The study by the VPC, based on a national news clipping service and Internet survey taken from January 1, 2005, through June 30, 2005, is considered by VPC as one of the largest and most comprehensive studies ever conducted on murder-suicide. During this six-month period, at least 591 Americans died in 264 murder-suicides, and almost all murder-suicides (92 percent) involved a firearm. Using these figures, the VPC estimates that nearly 1,200 Americans die each year in murder-suicides.
The racial makeup of those cases was not reported in the study.
Emphasizing that she was looking at the case as an outsider, Hollie assessed, given both of the Shaws' commitment to service in the Black community, theirs might have been an "altruistic" suicide, similar to cases involving people in the military.
"It involved an excessive sense of duty," she said. "Because they were somewhat activists and recognized people in the community - that weighed on them heavily. The more, in fact, that they were self-sacrificing is what defines it. That's probably what they had more than any other kind of suicide."
Hollie further stated the Shaws would have had to meet four strong indicators: their social situation, their emotional status, behavioral patterns and verbal statements expressing their wish to be dead. Seeing how one could have completed all four indicators, she assessed, however, for both to have completed them at the exact same time is extremely remote.
"People don't usually fit the same indicators at the same time ... that's a bit more rare," said Hollie. "With the [alleged] suicide pact, both would have had to possess that desire strong enough. Generally, what you have is one at a different state than the other, who is trying to coax the other one through."
Other factors remain that seemingly do not match with the Shaws' situation. As printed in The Dallas Examiner's March 20 issue, to many of Rufus' friends, who spoke of his possessing an indomitable spirit, the decision to take his own life seemed extremely uncharacteristic. However, Rufus was diagnosed with prostate cancer, the severity of it still unknown, but it could have caused enough of a depression for him to lose his will to live.
Still, associates of Lynn reported her determination to rebound from her recent troubles. She was accused of forging a document on District Attorney Craig Watkins' letterhead to avoid paying a loan and resigned as DART board chairman. Additionally, Jim Schultze, a columnist for the Dallas Observer, had just informed them of his intent to release several e-mails, which would not portray Lynn or her closest associates in a favorable life. These factors combined had the potential to destroy her standing in the community.
All of those issues would have been enough to at least ponder suicide, Hollie assessed.
"Absolutely, that would have been enough," she said.
However, friends and associates saw what they perceived to be inconsistencies with one intent on killing themselves. Lynn had been reportedly shopping at 5:30 p.m. the day of her death. That evening, when their bodies were discovered, a full meal had been prepared and two plates of food sat unfinished on the dinner table. When they were found, they were fully dressed. Despite calls and messages to friends and loved ones, there was no suicide note. Finally, in his call to Sen. Royce West, their family attorney, he spoke of enemies who would see to it that they were dead by the end of the day.
According to Dr. Donna Holland Barnes, President and CEO of National Organization for People of Color Against Suicide, none of these behaviors were inconsistent with suicide. With regard to Lynn's making plans for the future, Barnes explains that people who contemplate suicide are often ambivalent to the end, part of them wanting to live, the other part wishing to die. She stated of course they would be fully clothed, "Why wouldn't they be clothed?" she asked, adding that they knew they would be discovered and would not want to be found undressed. With regard to Rufus' statement about their enemies, she stated, it may be a last ditch effort to escape the humiliation associated with suicide or even an attempt to make sure their life insurance would cover their death.
But what about the unshakable feeling throughout the Black community that foul play was involved? While Barnes said she could not rule out a double homicide, she did provide a possible explanation for some of the numerous doubts that abound. The Black community in Dallas was grieving. Denial and anger are early stages of grief. She explained that the FBI indictments of many of our most outspoken Black leaders, combined with the deaths of Rufus and Lynn may have sent the community into a state of mourning. Barnes, who knows too well the impact of suicide on loved ones, having lost a son to suicide, said the community needed an opportunity to heal and suggested a town meeting to discuss their feelings of grief.
In the final analysis, the Shaws' death at least suggests the need for Blacks in Dallas to depend on their already strong spiritual roots and strong community bond to help each other admit weakening states due to the constant pressures of being Black in America and not be afraid to seek help.
"So many of us and people in our community are under pressure, doing various things," Toska Medlock Lee, a neighbor of the Shaws, said during the vigil held outside of their homes the day after their deaths. "We don't know what goes on behind the doors of people's homes. And we don't understand why people do what they, when their rope is breaking."
Barnes said her organization is available to support those struggling to accept the deaths of the Shaws. NOPCAS is a 501c (3) not-for-profit organization founded by three African American suicide survivors. For more information about suicide among Blacks, or support, visit www.nopcas.com or contact the organization at 202-549-6039.
Tuala Williams contributed to this story.
Wednesday, April 16, 2008
For Black Men, a One-Hour Doctor Visit Could Be the First Step Toward Optimum Health
For many African-American men, a one-hour visit to the doctor could be the first step toward a longer life.
"In general, women take more opportunities for primary health care," Dr. David Patterson, a veteran physician based in Washington, D.C., told BlackAmericaWeb.com. "It’s harder to get black men to go to the doctor on a routine basis."
According to health care experts, black men have far worse health than any other racial group in America, and the reasons are both simple and complex. They include racial discrimination, a lack of affordable health services, poor health education, cultural barriers, poverty, employment that does not carry health insurance and insufficient medical and social services catering to black men. Consider these statistics: Black men live 7.1 years less than other racial groups. They have higher death rates than women for all leading causes of death. They experience disproportionately higher death rates in all the leading causes of death. Black men have a higher incidence and a higher rate of death from oral cancer. Black men are five times more likely to die of HIV/AIDS.
Forty percent of black men die prematurely from cardiovascular disease, compared to 21 percent of white men. Forty-four percent of black men are considered overweight. Twenty-four percent are obese. Black men suffer from more preventable, treatable oral diseases. Black men have a higher incidence of diabetes and prostate cancer. And black men have a high suicide rate.
The state of black men and their health has been an ongoing concern for organizations across the country.
Last year, for example, the Congressional Black Caucus Foundation co-sponsored a symposium to address the state of health and wellness of black men and how the issue affects women, families and communities.
"Historically, progress in addressing racial and ethnic health disparities and other minority health issues has resulted from the complicated and often sensitive interplay of research, policy and political action," Rep. Donna Christensen (D-VI) said in a statement.
Also last year, the Illinois Department of Public Health encouraged African-American men to take charge of their health by making better choices and taking advantage of testing for certain diseases and conditions.
"We continue to see disparities in the health of black men," health department director Dr. Eric E. Whitaker said in a statement.
"Black men are suffering from high blood pressure, heart disease, and prostate cancer at higher rates than their counterparts," Whitaker said. "While efforts are being made to provide better access to quality healthcare, black men must also do their part to stay healthy. Eat healthy, exercise, and have routine tests done to ensure you don’t have a problem."
Members of the National Medical Association say they serve a disproportionately high number of patients who are African-American in urban and rural areas. A large number of patients served, they said, are poor, uninsured and under-insured.
Health care professionals say many black men -- especially older black men -- are distrustful of white physicians and will not visit a doctor until it’s too late. The National Medical Association has created a mentoring prorgam "to develop a greater number of African-American residents and students who will become leaders in clinical and academic medicine" in hopes of helping more black patients.
Sadly, homicide is one of the leading causes of death facing black men. Overwhelmingly, blacks men are more likely than whites to die as a result of homicide. Overall, blacks are five times more likely to be murdered than whites and black men under 25 years of age are 15 times more likely to die by homicide than their white counterparts. The murder rate for black males over 25 is nearly seven times that of white males.
Patterson, however, said there are five areas in health care that African American men can control: Diet, exercise, alcohol consumption, smoking and obesity.
And according to Patterson, who has been practicing medicine for 23 years in D.C., black men should get screened for prostate cancer starting at 40 years old, get an annual physical, blood pressure checks and find ways to manage stress. He said stress can exacerbate illnesses such as cancer and other serious diseases.
"African-American men tend to keep things closer to the vest and don’t find ways to relieve stress," Patterson said.
"In general, women take more opportunities for primary health care," Dr. David Patterson, a veteran physician based in Washington, D.C., told BlackAmericaWeb.com. "It’s harder to get black men to go to the doctor on a routine basis."
According to health care experts, black men have far worse health than any other racial group in America, and the reasons are both simple and complex. They include racial discrimination, a lack of affordable health services, poor health education, cultural barriers, poverty, employment that does not carry health insurance and insufficient medical and social services catering to black men. Consider these statistics: Black men live 7.1 years less than other racial groups. They have higher death rates than women for all leading causes of death. They experience disproportionately higher death rates in all the leading causes of death. Black men have a higher incidence and a higher rate of death from oral cancer. Black men are five times more likely to die of HIV/AIDS.
Forty percent of black men die prematurely from cardiovascular disease, compared to 21 percent of white men. Forty-four percent of black men are considered overweight. Twenty-four percent are obese. Black men suffer from more preventable, treatable oral diseases. Black men have a higher incidence of diabetes and prostate cancer. And black men have a high suicide rate.
The state of black men and their health has been an ongoing concern for organizations across the country.
Last year, for example, the Congressional Black Caucus Foundation co-sponsored a symposium to address the state of health and wellness of black men and how the issue affects women, families and communities.
"Historically, progress in addressing racial and ethnic health disparities and other minority health issues has resulted from the complicated and often sensitive interplay of research, policy and political action," Rep. Donna Christensen (D-VI) said in a statement.
Also last year, the Illinois Department of Public Health encouraged African-American men to take charge of their health by making better choices and taking advantage of testing for certain diseases and conditions.
"We continue to see disparities in the health of black men," health department director Dr. Eric E. Whitaker said in a statement.
"Black men are suffering from high blood pressure, heart disease, and prostate cancer at higher rates than their counterparts," Whitaker said. "While efforts are being made to provide better access to quality healthcare, black men must also do their part to stay healthy. Eat healthy, exercise, and have routine tests done to ensure you don’t have a problem."
Members of the National Medical Association say they serve a disproportionately high number of patients who are African-American in urban and rural areas. A large number of patients served, they said, are poor, uninsured and under-insured.
Health care professionals say many black men -- especially older black men -- are distrustful of white physicians and will not visit a doctor until it’s too late. The National Medical Association has created a mentoring prorgam "to develop a greater number of African-American residents and students who will become leaders in clinical and academic medicine" in hopes of helping more black patients.
Sadly, homicide is one of the leading causes of death facing black men. Overwhelmingly, blacks men are more likely than whites to die as a result of homicide. Overall, blacks are five times more likely to be murdered than whites and black men under 25 years of age are 15 times more likely to die by homicide than their white counterparts. The murder rate for black males over 25 is nearly seven times that of white males.
Patterson, however, said there are five areas in health care that African American men can control: Diet, exercise, alcohol consumption, smoking and obesity.
And according to Patterson, who has been practicing medicine for 23 years in D.C., black men should get screened for prostate cancer starting at 40 years old, get an annual physical, blood pressure checks and find ways to manage stress. He said stress can exacerbate illnesses such as cancer and other serious diseases.
"African-American men tend to keep things closer to the vest and don’t find ways to relieve stress," Patterson said.
New Report by the Intercultural Cancer Council cites little progress in disparities
Although more people than ever before are living with cancer, it remains the second leading cause of death in the United States, after heart disease. Ethnic and racial minorities, the elderly and the poor – all medically underserved communities – are more likely to get cancer and die from it. A new report issued by the Intercultural Cancer Council calls for action to reverse the trend.
The report updates a similar study released by the Intercultural Cancer Council four years ago. Lovell Jones, co-founder of the advocacy group, sees little progress since the first study. "When we looked at the recommendations, they still hold true four years later. Very few, if any of them, have been implemented."
Jones cites prostate cancer as an example of the ever widening gap between African American and white males. He notes there is a 60 percent higher mortality rate for African Aemricans and a "two-fold or greater" rate of occurrence.
Jones says the death rate from cervical cancer in poor Appalachian regions of the eastern United States is higher than the national rate. The report also finds high cancer incidence and death rates – as high as in developing countries – among people in Hawaii and other U.S. islands in the Pacific.
These are the people who smoke heavily, don't get regular medical exams, are frequently diagnosed after their cancer has spread and die more frequently from the disease. Jones says they falling through the cracks in the healthcare system for a number of reasons including a legacy of discrimination in policies and practices. "It could be defined as 'institutional racism' as opposed to individual racism. It's economics. It's knowledge. It is cultural habits. It is where one lives."
Jones says the health care system is failing because it is so disconnected from the people it needs to serve. "We think about addressing access, but we don't think about addressing transportation. We think about addressing the issue of finding some gene, but we don't think about how to implement that in terms of a service operation."
Jones joins the authors of the Intercultural Cancer Council report to call on the President, Congress and the American people to make health care a top priority. The report details an action plan for public policy that promotes greater access to quality care for minorities and the poor. Unless more is done, it warns, "disparities will only increase over the next half-century." Lovell Jones says taking steps now to help the medically underserved will help build a healthier future for all Americans.
The report updates a similar study released by the Intercultural Cancer Council four years ago. Lovell Jones, co-founder of the advocacy group, sees little progress since the first study. "When we looked at the recommendations, they still hold true four years later. Very few, if any of them, have been implemented."
Jones cites prostate cancer as an example of the ever widening gap between African American and white males. He notes there is a 60 percent higher mortality rate for African Aemricans and a "two-fold or greater" rate of occurrence.
Jones says the death rate from cervical cancer in poor Appalachian regions of the eastern United States is higher than the national rate. The report also finds high cancer incidence and death rates – as high as in developing countries – among people in Hawaii and other U.S. islands in the Pacific.
These are the people who smoke heavily, don't get regular medical exams, are frequently diagnosed after their cancer has spread and die more frequently from the disease. Jones says they falling through the cracks in the healthcare system for a number of reasons including a legacy of discrimination in policies and practices. "It could be defined as 'institutional racism' as opposed to individual racism. It's economics. It's knowledge. It is cultural habits. It is where one lives."
Jones says the health care system is failing because it is so disconnected from the people it needs to serve. "We think about addressing access, but we don't think about addressing transportation. We think about addressing the issue of finding some gene, but we don't think about how to implement that in terms of a service operation."
Jones joins the authors of the Intercultural Cancer Council report to call on the President, Congress and the American people to make health care a top priority. The report details an action plan for public policy that promotes greater access to quality care for minorities and the poor. Unless more is done, it warns, "disparities will only increase over the next half-century." Lovell Jones says taking steps now to help the medically underserved will help build a healthier future for all Americans.
April 14 is African American Prostate Awareness
The Guilford County Board of Commissioners proclaimed the day should be used to mobilize the black community to learn the health risks associated with poor prostate health. There are an estimated 20,000 people living with prostate cancer across the Triad, and 67 percent of African-American men diagnosed die from the curable disease.Guilford County is teaming up with the American Cancer Society, the National Cancer Institute and the High Point-based Nia's Ark
Dr Rick Kittles and genetics research
Dr. Kittles recieved his Ph.D. Biological Sciences from George Washington University and from there he continued his pioneering genetic research of prostate cancer in the African American community. Along the way he established large-scale, high throughput genotyping and DNA sequencing. This led to Kittles' research exploits in genealogy and in the studies of population history-to the extent that he was able to develop a very large database of genetic DNA markers which many companies now use to trace a subject's DNA to Africa
Application of nanotechnology for enhanced early detection of prostate cancer in African-American men: Abstract 4741
Once limited to the electronics industry, semiconductor material may hold the key to improving the detection of prostate cancer among African-American men. Nanotechnology using quantum dots made from semiconductor material allowed researchers to detect the presence of six biomarkers associated with prostate cancer.
If proven in clinical studies, the nanotechnology will enable physicians to diagnose prostate cancer at earlier stages, which is particularly important for African-American men.
“African-American men appear to have the highest rate of prostate cancer incidence in the world,” said Catherine M. Phelan, M.D., Ph.D., an assistant professor in cancer prevention and control at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Fla. “ In addition, their prostate cancer mortality rate is twice as high as the rate for white Americans.”
Early detection is crucial. Among African-American men diagnosed with early stage prostate cancer, five-year survival rates are almost 100 percent. For men diagnosed with more advanced disease, five-year survival rates are 29 percent, according to Phelan.
To improve early detection, Phelan and her colleagues investigated quantum dot antibody conjugates. Quantum dots (QD) measure 5-20 nanometers in diameter. For comparison, a human hair measures 100,000 nm in diameter. The small size of the QDs results in new optical properties that allow observers to determine the size and energy of the QD and where it will emit light along the color spectrum.
“Smaller QDs are higher energy and emit in the blue part of the spectrum, whereas the larger-sized but lower-energy QDs emit light in the red part of the spectrum,” Phelan explained.
“If you want to look at a particular known protein in the blood, such as prostate specific antigen (PSA), you can attach the specific antibody for that protein to the QD and, using a laser, observe where the emission peak lies in the color spectrum. The height of the peak represents the amount of protein in the blood sample,” she said.
Phelan and her colleagues targeted established prostate cancer biomarkers: PSA, kallikrein 2 (KLK2), kallikrein 14 (KLK14), osteoprotegerin (OPG), antip53Ab, caveolin-1 (Cav-1) and interleukin-6 (IL-6). Using an African-American prostate cancer case-control collection, the researchers observed that the bioconjugated QDs displayed a spectral shift of the maximum position on average by 4 nm in comparison with nonconjugated QDs.
“The benefit of the observation may lie in the fact that the shift is different for each antibody, thus will show a peak at different wavelengths,” the researchers reported.
Phelan said there are two main advantages to QD technology over current methods, such as measuring PSA. First, the optical properties of QDs allow protein detection at lower levels when the tumor is in its earliest stages. Second, the technology offers the ability to detect multiple biomarkers, which will be more effective than a single biomarker.
“The technology can be used for detection of any cancer in any ethnic group,” Phelan said. The biomarkers in the study are unique to African-American men with prostate cancer, but the baseline levels of the proteins may differ among ethnic groups.
The technology could also be used to detect risk of recurrence, although the biomarkers may be different than for early detection, she said.
If proven in clinical studies, the nanotechnology will enable physicians to diagnose prostate cancer at earlier stages, which is particularly important for African-American men.
“African-American men appear to have the highest rate of prostate cancer incidence in the world,” said Catherine M. Phelan, M.D., Ph.D., an assistant professor in cancer prevention and control at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Fla. “ In addition, their prostate cancer mortality rate is twice as high as the rate for white Americans.”
Early detection is crucial. Among African-American men diagnosed with early stage prostate cancer, five-year survival rates are almost 100 percent. For men diagnosed with more advanced disease, five-year survival rates are 29 percent, according to Phelan.
To improve early detection, Phelan and her colleagues investigated quantum dot antibody conjugates. Quantum dots (QD) measure 5-20 nanometers in diameter. For comparison, a human hair measures 100,000 nm in diameter. The small size of the QDs results in new optical properties that allow observers to determine the size and energy of the QD and where it will emit light along the color spectrum.
“Smaller QDs are higher energy and emit in the blue part of the spectrum, whereas the larger-sized but lower-energy QDs emit light in the red part of the spectrum,” Phelan explained.
“If you want to look at a particular known protein in the blood, such as prostate specific antigen (PSA), you can attach the specific antibody for that protein to the QD and, using a laser, observe where the emission peak lies in the color spectrum. The height of the peak represents the amount of protein in the blood sample,” she said.
Phelan and her colleagues targeted established prostate cancer biomarkers: PSA, kallikrein 2 (KLK2), kallikrein 14 (KLK14), osteoprotegerin (OPG), antip53Ab, caveolin-1 (Cav-1) and interleukin-6 (IL-6). Using an African-American prostate cancer case-control collection, the researchers observed that the bioconjugated QDs displayed a spectral shift of the maximum position on average by 4 nm in comparison with nonconjugated QDs.
“The benefit of the observation may lie in the fact that the shift is different for each antibody, thus will show a peak at different wavelengths,” the researchers reported.
Phelan said there are two main advantages to QD technology over current methods, such as measuring PSA. First, the optical properties of QDs allow protein detection at lower levels when the tumor is in its earliest stages. Second, the technology offers the ability to detect multiple biomarkers, which will be more effective than a single biomarker.
“The technology can be used for detection of any cancer in any ethnic group,” Phelan said. The biomarkers in the study are unique to African-American men with prostate cancer, but the baseline levels of the proteins may differ among ethnic groups.
The technology could also be used to detect risk of recurrence, although the biomarkers may be different than for early detection, she said.
Health disparities: genetics plays an important role in cancer detection, prognosis among minorities
SAN DIEGO – Research reported at the 2008 Annual Meeting of the American Association for Cancer Research, April 12-16, suggests that poorer outcomes for breast cancer and prostate cancer among minorities may be due to biologic factors. In addition, researchers present a new theory on why a recent decline in breast cancer rates was less pronounced among African-American women, and offer data on a relatively simple means of reducing racial disparities in breast cancer care.
Gene expression profiling reveals tumor immunobiological differences in prostate cancer between African-American and European-American men: Abstract 512
Prostate cancer appears to be distinctly different in African-American men compared with European-American men, according to researchers at the National Cancer Institute (NCI) who found significant differences in expression of numerous genes in tumor samples taken from the two racial groups.
Many of these genes were related to inflammation and immune system regulation, suggesting that pathogens could be involved in race/ethnic differences that lead to the development of these tumors, the researchers say. Some of the genes were also linked to cancer spread.
Although further study is needed to confirm their hypothesis of possible viral involvement in cancer, the team believes that these novel findings could help explain why both the incidence of, and death rates from, prostate cancer are increased among African-American men.
“We don’t think the worse outcomes we see in African-American prostate cancer patients are due to issues of socioeconomic and sociodemographic differences alone,” said lead author, Tiffany Wallace, Ph.D., a postdoctoral fellow in the Laboratory of Human Carcinogenesis at the NCI. “So we are trying to understand if differences in genetics and biology play a discernable role, and this study suggests they do.”
NCI researchers obtained gene expression profiles from tumors removed during surgery from 33 African-American and 36 European-American patients using gene microarray technology. They also obtained samples of surrounding non-tumor prostate tissue from seven of the African-American and 11 of the European-American patients. They then compared the combined tumor profiles to profiles from non-cancerous tissue, and similar differences in tumor marker expression that other research groups had already detected.
Sorting the samples according to race, they found the differences in gene expression. Of significance was over-expression of indoleamine-2,3-dioxygenase, an immune system modulating enzyme that tumors use to subvert immune-system surveillance, and the “self” antigens HLA-E and HLA-G that additionally inhibit immune responses through different mechanisms.
“These genes are well-known contributors of immunologic tolerance in tumors,” she said. Additionally, there was a distinctive interferon signature in gene over-expression in the African-American patients, which is associated with an immune system response against foreign invaders such as viruses.
One puzzling finding: genes that activate the immune system and genes that suppress it were both more highly expressed in the African-American patients. Wallace says this suggests the immune system is fighting the cause of the cancer, which could be a pathogenic invader. Alternatively, the discovered gene signature may reflect merely the presence of a chronic low-level inflammation that is more prevalent in the tumors of the African-American patients, she says. It could also mean that prostate tumors in these men have ways of suppressing the immune system, which explains why their tumors are more aggressive, she adds.
“Something is different in the tumor microenvironment between the group of patients we studied and it has to do with tumor immunobiology,” Wallace said. “We are intrigued with these findings, which we are continuing to research.”
Gene expression profiling reveals tumor immunobiological differences in prostate cancer between African-American and European-American men: Abstract 512
Prostate cancer appears to be distinctly different in African-American men compared with European-American men, according to researchers at the National Cancer Institute (NCI) who found significant differences in expression of numerous genes in tumor samples taken from the two racial groups.
Many of these genes were related to inflammation and immune system regulation, suggesting that pathogens could be involved in race/ethnic differences that lead to the development of these tumors, the researchers say. Some of the genes were also linked to cancer spread.
Although further study is needed to confirm their hypothesis of possible viral involvement in cancer, the team believes that these novel findings could help explain why both the incidence of, and death rates from, prostate cancer are increased among African-American men.
“We don’t think the worse outcomes we see in African-American prostate cancer patients are due to issues of socioeconomic and sociodemographic differences alone,” said lead author, Tiffany Wallace, Ph.D., a postdoctoral fellow in the Laboratory of Human Carcinogenesis at the NCI. “So we are trying to understand if differences in genetics and biology play a discernable role, and this study suggests they do.”
NCI researchers obtained gene expression profiles from tumors removed during surgery from 33 African-American and 36 European-American patients using gene microarray technology. They also obtained samples of surrounding non-tumor prostate tissue from seven of the African-American and 11 of the European-American patients. They then compared the combined tumor profiles to profiles from non-cancerous tissue, and similar differences in tumor marker expression that other research groups had already detected.
Sorting the samples according to race, they found the differences in gene expression. Of significance was over-expression of indoleamine-2,3-dioxygenase, an immune system modulating enzyme that tumors use to subvert immune-system surveillance, and the “self” antigens HLA-E and HLA-G that additionally inhibit immune responses through different mechanisms.
“These genes are well-known contributors of immunologic tolerance in tumors,” she said. Additionally, there was a distinctive interferon signature in gene over-expression in the African-American patients, which is associated with an immune system response against foreign invaders such as viruses.
One puzzling finding: genes that activate the immune system and genes that suppress it were both more highly expressed in the African-American patients. Wallace says this suggests the immune system is fighting the cause of the cancer, which could be a pathogenic invader. Alternatively, the discovered gene signature may reflect merely the presence of a chronic low-level inflammation that is more prevalent in the tumors of the African-American patients, she says. It could also mean that prostate tumors in these men have ways of suppressing the immune system, which explains why their tumors are more aggressive, she adds.
“Something is different in the tumor microenvironment between the group of patients we studied and it has to do with tumor immunobiology,” Wallace said. “We are intrigued with these findings, which we are continuing to research.”
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