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Jay Fowke of UTHSC Receives Department of Defense Grant for Research on Link Between Racial Disparities and Prostate Cancer

Jay Fowke, PhD, MPH is chief of the Division of Epidemiology and professor of Preventive Medicine. (Photo by Connor Bran/UTHSC).

As the most common non-skin cancer in America, prostate cancer affects one in nine men. There are many risk factors that make some men more susceptible than others, and among those factors are race and ethnicity.

Jay Fowke, PhD, MPH, chief of the Division of Epidemiology and professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center (UTHSC), has been awarded an $843,694 grant from the Department of Defense for his research project entitled, “Prostate Tissue Gene Expression Patterns Predict Prostate Tissue Inflammation, Aggressive Prostate Cancer, and a Poorer Prognosis Among Black and White Men.” The project focuses on the overarching challenge of distinguishing aggressive from indolent disease in men newly diagnosed with prostate cancer, with an emphasis on data science and analytics, population science, and tumor and microenvironment biology.

“Prostate cancer is a disease that develops over a long period of time, and we don’t really understand what that process is of going from normal prostate cells and tissue to cancer,” Dr. Fowke said. “What we do know is that there are some established risk factors for prostate cancer, such as age and family history.”

In addition to these established risk factors, Dr. Fowke’s research also explores a racial disparity component; specifically, the fact that African-American men are more likely to develop and die from prostate cancer than Caucasian, Hispanic/Latin, and Asian men.

“We know that black men, for some reason, are more likely to develop and die from prostate cancer than other groups of men and we have almost no idea why that is the case,” Dr. Fowke said. “We don’t think it’s entirely genetic, although there could be some sort of inherited component to that, but there could also be a cultural, lifestyle component to that, and the two could interact in ways we don’t understand right now.”

Dr. Fowke’s work attempts to look at the environmental, non-genetic components of prostate cancer risk and then combine it with the established genetic components as a method to tease out how the seemingly disparate two talk to each other to advance prostate cancer across all groups of men.

“We’re trying to understand why these differences exist across races. Is it just a genetic factor that drives this or is it some combination of cultural, lifestyle effects with genetic factors that pair to advance prostate cancer in, this case, African-American men.” Dr. Fowke said.

“We think that one part of what drives prostate cancer is what we generally refer to as inflammation,” Dr. Fowke said. “Sometimes, the immune system should turn on and it then should turn off. When it does not turn off, or does not turn off in the right way, it sometimes creates an inflammatory event that is not curtailed and can cause tissue damage on its own. The immune system could be sending cells into the prostate tissue to address something, but it doesn’t turn off. It stays and persists at a low-level state, which can cause damage and advance cancer development.”

From collected circumstantial data, Dr. Fowke believes those events happen more readily in African-American men than other groups of men, as they are more likely to develop other inflammatory diseases such as cardiovascular disease and diabetes. Dr. Fowke and his research team will observe the expression of genes in prostate tissue that they believe are important in developing prostate cancer, see if the pattern of gene expression is linked with levels of inflammation in the tissue, and whether these patterns of gene expression differ with race. “We hypothesize that inflammation in the prostate may play a more important role in African-American men than other groups, leading to a different gene expression patterns, and this might help explain race differences in prostate cancer.”