Prostate Cancer Research News: How Does It Apply To Me?

In addition to having the lowest mortality rate, the article claims that Asian-American men as a single ethnic group have the lowest incidence of prostate cancer. However, the authors state when Asian men are diagnosed, they have worse prognostic profiles than other men, although their survival rate is better.

Asian men may have the lowest mortality rate because they may believe that their chances of survival are best if an aggressive treatment is taken immediately upon diagnosis, rather than waiting or choosing a less intensive form of treatment. Also, Asian men may have the lowest incidence because fewer Asian men are getting screened for prostate cancer than non-Asians. I believe both of these were true for my father. He may have survived his bout with cancer because of his choice of treatment and he most likely would not have undergone a prostate cancer screening if it were not for his HMO recommending the procedure.

So, if traditional prognostic factors (age, stage, treatment, year of diagnosis, and socioeconomic status) do not explain better survival rates among Asian men, what does?

One possible reason could be that the Asian men in the study are the most likely to have health insurance, which means they are more likely to get screened and have access to various forms of treatment compared to those without insurance. If the sample was taken from a cancer registry, it may not include men who are uninsured, which means it may not be truly representative of the general public. Also, many Asians are uninsured, especially first generation immigrants, which are likely to be the men in the study given the older age of the participants. This could directly affect survival rates in Asian men since they may not be receiving proper screening and preventative services.

Secondly, in addition to lack of health insurance, many immigrants from Asia hold a different perspective and philosophy about medicine. Where Western medicine is more prevention-focused, Eastern medicine tends to focus on treatment of disease. Western medicine encourages the individual to take a more proactive approach in managing one's health, and in Eastern medicine, the individual is more reactive to an illness or disease and the emphasis is on the treatment. Therefore, an Asian man diagnosed with prostate cancer who holds an Eastern approach to medicine could be more likely to desire an aggressive treatment.

I cannot deny that factors such as access to health insurance, personal philosophy of medicine, diet and exercise play a role in prostate cancer survivorship. However, I think it is incredibly difficult to make generalizations, especially about health, that can accurately explain incidence and outcome of certain diseases. Medical research is very challenging because it attempts to inform the public at large, but by studying a pool of participants that are extremely complex; each person's background and beliefs significantly contribute to what makes each individual unique. Nonetheless, medical research is very important and participation from all ethnic groups and genders are needed in order to improve the generalizability of research findings to individuals like you and me.