The Department of Defense has awarded $1.9 million to Jay H. Fowke, PhD, MPH, MS, chief of the Division of Epidemiology and professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center (UTHSC), to study why Puerto Rican men have higher than expected prostate cancer mortality.
Puerto Rican men have a higher prostate cancer mortality compared to non-Hispanic white or Hispanic men living in the United States. Prostate cancer mortality among Puerto Rican men is second only to black men in the U.S., but has remained largely unstudied. Most studies combine men from all Spanish-speaking regions into a single group, labeling them Hispanic or Latino, and ignore regional cultural, economic, and lifestyle differences that could impact prostate cancer prognosis. Diabetes is more prevalent in Puerto Rico than in any state or territory. While it is known that diabetes and obesity adversely affect prostate cancer prognosis, the role of diabetes specifically on prostate cancer mortality in Puerto Rico is unknown.
Dr. Fowke and his team will work to determine if diabetes interacts with obesity to increase aggressiveness of prostate cancer in Puerto Rican or black men. They will examine differences in how diabetes and obesity interact between Puerto Rican, non-Hispanic white, and black men, looking for mechanisms that might explain the unexpectedly high prostate cancer mortality in Puerto Rico. The team will compare the effects of diabetes and obesity on prostate cancer prognosis among Puerto Rican patients at the San Juan VA Medical Center to black and non-Hispanic white patients at the Durham VA Medical Center in North Carolina. The studies will involve comparing gene expression pathways in prostate tissue between diabetic prostate cancer patients in the three ethnic groups. This analysis will be the first genomic investigation of prostate cancer in Puerto Rico, and the first to investigate the diabetes impact on prostate tissue across these groups. The team’s findings can then be translated to personalized clinical interventions.
“With this study, we hope to produce results that can be used to develop clinical trials to test careful diabetes and obesity characterization, and personalized diabetes management with obesity to improve prostate cancer prognosis for Puerto Rican, black, and non-Hispanic white patients,” Dr. Fowke said.