Re: Blacks With Equal Care Still More Likely to Die of Some Cancers

[Guest guest]

Hi folks:

People tend to try to look for complicated answers when a very simple

answer may be the solution.

I speculate it is much more likely that the reason black-skinned people

get more of these cancers is the fact that their skin pigmentation

prevents them from getting the vitamin D they need to prevent the

disease.

One study posted here recently found a truly dramatic reduction in the

incidence of new cases of all cancers in post-menopausal females who

were supplemented with both calcium and vitamin D, compared with

placebo. And a second paper, also posted here, reported that among

males already diagnosed with prostate cancer, those with the lowest

blood levels of vitamin D were more than SIX times as likely to die from

the disease than those with the highest blood levels. There was no

supplementation in this case.

These studies remain to be confirmed by other investigators. But, as

stated here previously, I am not gonna wait five to ten years until we

see confirmation. It seems pretty clear that while huge benefits may

accrue from supplementing vitamin D, it is unlikely there will be

significant risks, so long as blood levels of 25(OH)D are monitored and

found to be within appropriate ranges.

Rodney.

--- In , Francesca Skelton <fskelton@...>

wrote:

>

>

> By Rob Stein

> Washington Post Staff Writer

> Wednesday, July 8, 2009

>

> African Americans are less likely than whites to survive breast,

prostate

> and ovarian cancer even when they receive equal treatment, according

to a

> large study that offers provocative evidence that biological factors

play a

> role in at least some racial disparities.

>

> The first-of-its-kind study, involving nearly 20,000 cancer patients

> nationwide, found that the gap in survival between blacks and whites

> disappeared for lung, colon and several other cancers when they

received

> identical care as part of federally funded clinical trials. But

disparities

> persisted for prostate, breast and ovarian cancer, suggesting that

other

> factors must be playing a role in the tendency of blacks to fare more

> poorly.

>

> For decades, studies have shown that poor people and minorities are

more

> likely to live shorter, sicker lives, and are less likely to survive a

host

> of illnesses, including many cancers. Studies have indicated that the

> disparities were largely the result of poor people and minorities

getting

> inferior care; they are less likely to have health insurance and

receive

> routine preventive care, they frequently get diagnosed later, and they

often

> undergo less aggressive treatment once they are diagnosed.

>

> The new study is another chance to weigh biology against disparities

in the

> quality of care.

>

> " There is good news and puzzling news in our results, " said Kathy S.

Albain

> of Loyola University, whose findings were published online today by

the

> Journal of the National Cancer Institute.

>

> " When there's a level playing field with the same quality of care,

African

> Americans survive just as well as other races from some of our most

common

> cancers, which is reassuring news and points us nationally toward a

need to

> make sure there is quality of care and equal access to all, " Albain

said.

> " But for prostate, ovarian and breast [cancer], it's not access to

care.

> There's something else. And we need to sort that out. "

>

> Other researchers said the findings were groundbreaking.

>

> " I believe this is a landmark analysis, " said A. Newman of the

> University of Michigan. " There seems to be something associated with

racial

> and ethnic identity that seems to confer a worse survival rate for

African

> Americans. I think it's likely to be hereditary and genetic factors. "

>

> A growing body of evidence has suggested that biological factors may

be

> playing a role in health disparities. Genetic variations, for example,

> appear to make some therapies more effective or less toxic for some

people

> than others. That idea, however, has been controversial and has raised

> concern that it could distract from the major cause of disparities,

such as

> poverty, prejudice and geographic variation in quality of care.

>

> Some experts cautioned that the study could not rule out the effects

of

> socioeconomic and environmental factors earlier in life, and expressed

worry

> that the findings could reinforce old prejudices.

>

> " When I hear scientists talking about racial differences, I worry that

it

> starts to harken back to arguments about genetic inferiority, " said

Otis W.

> Brawley, chief medical officer of the American Cancer Society and an

African

> American.

>

> In the new study, Albain and her colleagues used data collected from

about

> 19,457 patients between 1974 and 2001 by the Southwest Oncology Group,

a

> National Cancer Institute-funded national cooperative of clinical

trials.

> Because all patients in the studies received the same treatment, if

poverty

> and other socioeconomic factors were to blame, then differences in

survival

> should remain constant across all cancers, the researchers reasoned.

>

> A detailed analysis of the data found no statistically significant

> association between race and survival for lung and colon cancer -- two

of

> the most common forms of cancer -- or for leukemia, lymphoma and

myeloma.

>

> But African Americans were still 49 percent more likely than whites to

die

> from early-stage postmenopausal breast cancer, 41 percent more likely

to die

> from early-stage premenopausal breast cancer, 61 percent more likely

to die

> from advanced ovarian cancer and 21 percent more likely to die from

advanced

> prostate cancer.

>

> Because all the cancers for which the disparity persisted were related

to

> gender, the findings suggest that the survival gap may be the result

of a

> complex interaction of differences in the biology of the tumors and

> inherited variations in genes that control metabolism of drugs and

hormones,

> Albain said.

>

> Some of the difference in breast cancer survival could be explained by

the

> fact that black women are more likely to get a more aggressive form of

the

> disease that is more difficult to treat. But part of Albain's study

and

> another analysis by researchers at the National Cancer Institute

involving

> more than 244,000 cancer patients nationwide found that could not

explain

> all the difference.

>

> " This is almost certainly related to a mix of factors across races

> pertaining to tumor biology and inherited factors, " Albain said.

>

> Albain disputed suggestions the study could be used to support racial

> prejudices.

>

> " We certainly aren't talking about 'genetic inferiority' or

stereotypes in

> our study (or implying it) and it would be a shame to have these

results

> misinterpreted by someone in this way, " Albain wrote in e-mail. " What

we are

> saying is that there is something that 'tracks' with African ancestry

only

> in these three diseases. . . . Once we discover the explanation for

our

> findings, tailored treatments will benefit all races. "

>

> But Brawley, who speaks widely on issues of racial disparity, and

others

> argued that access to high-quality care remains the dominant problem.

> Socioeconomic factors that occur earlier in life may explain the

findings,

> Brawley said. For example, poor people and minorities are more likely

to

> grow up in polluted neighborhoods and have been hit hardest by the

obesity

> epidemic, which could lead to more difficult-to-treat cancers, he

said.

>

> " These differences are not due to inherent genetics. They are due to

the

> effects of environmental factors like diet and exercise and obesity on

> biology, " Brawley said.

>

[Guest guest]

There are MDs who are thinking the same thing as you state below, Rodney:

http://www.washingtonpost.com/wp-dyn/articles/A43711-2004May20.html

- Diane

> >

> >

> > By Rob Stein

> > Washington Post Staff Writer

> > Wednesday, July 8, 2009

> >

> > African Americans are less likely than whites to survive breast,

> prostate

> > and ovarian cancer even when they receive equal treatment, according

> to a

> > large study that offers provocative evidence that biological factors

> play a

> > role in at least some racial disparities.

> >

> > The first-of-its-kind study, involving nearly 20,000 cancer patients

> > nationwide, found that the gap in survival between blacks and whites

> > disappeared for lung, colon and several other cancers when they

> received

> > identical care as part of federally funded clinical trials. But

> disparities

> > persisted for prostate, breast and ovarian cancer, suggesting that

> other

> > factors must be playing a role in the tendency of blacks to fare more

> > poorly.

> >

> > For decades, studies have shown that poor people and minorities are

> more

> > likely to live shorter, sicker lives, and are less likely to survive a

> host

> > of illnesses, including many cancers. Studies have indicated that the

> > disparities were largely the result of poor people and minorities

> getting

> > inferior care; they are less likely to have health insurance and

> receive

> > routine preventive care, they frequently get diagnosed later, and they

> often

> > undergo less aggressive treatment once they are diagnosed.

> >

> > The new study is another chance to weigh biology against disparities

> in the

> > quality of care.

> >

> > " There is good news and puzzling news in our results, " said Kathy S.

> Albain

> > of Loyola University, whose findings were published online today by

> the

> > Journal of the National Cancer Institute.

> >

> > " When there's a level playing field with the same quality of care,

> African

> > Americans survive just as well as other races from some of our most

> common

> > cancers, which is reassuring news and points us nationally toward a

> need to

> > make sure there is quality of care and equal access to all, " Albain

> said.

> > " But for prostate, ovarian and breast [cancer], it's not access to

> care.

> > There's something else. And we need to sort that out. "

> >

> > Other researchers said the findings were groundbreaking.

> >

> > " I believe this is a landmark analysis, " said A. Newman of the

> > University of Michigan. " There seems to be something associated with

> racial

> > and ethnic identity that seems to confer a worse survival rate for

> African

> > Americans. I think it's likely to be hereditary and genetic factors. "

> >

> > A growing body of evidence has suggested that biological factors may

> be

> > playing a role in health disparities. Genetic variations, for example,

> > appear to make some therapies more effective or less toxic for some

> people

> > than others. That idea, however, has been controversial and has raised

> > concern that it could distract from the major cause of disparities,

> such as

> > poverty, prejudice and geographic variation in quality of care.

> >

> > Some experts cautioned that the study could not rule out the effects

> of

> > socioeconomic and environmental factors earlier in life, and expressed

> worry

> > that the findings could reinforce old prejudices.

> >

> > " When I hear scientists talking about racial differences, I worry that

> it

> > starts to harken back to arguments about genetic inferiority, " said

> Otis W.

> > Brawley, chief medical officer of the American Cancer Society and an

> African

> > American.

> >

> > In the new study, Albain and her colleagues used data collected from

> about

> > 19,457 patients between 1974 and 2001 by the Southwest Oncology Group,

> a

> > National Cancer Institute-funded national cooperative of clinical

> trials.

> > Because all patients in the studies received the same treatment, if

> poverty

> > and other socioeconomic factors were to blame, then differences in

> survival

> > should remain constant across all cancers, the researchers reasoned.

> >

> > A detailed analysis of the data found no statistically significant

> > association between race and survival for lung and colon cancer -- two

> of

> > the most common forms of cancer -- or for leukemia, lymphoma and

> myeloma.

> >

> > But African Americans were still 49 percent more likely than whites to

> die

> > from early-stage postmenopausal breast cancer, 41 percent more likely

> to die

> > from early-stage premenopausal breast cancer, 61 percent more likely

> to die

> > from advanced ovarian cancer and 21 percent more likely to die from

> advanced

> > prostate cancer.

> >

> > Because all the cancers for which the disparity persisted were related

> to

> > gender, the findings suggest that the survival gap may be the result

> of a

> > complex interaction of differences in the biology of the tumors and

> > inherited variations in genes that control metabolism of drugs and

> hormones,

> > Albain said.

> >

> > Some of the difference in breast cancer survival could be explained by

> the

> > fact that black women are more likely to get a more aggressive form of

> the

> > disease that is more difficult to treat. But part of Albain's study

> and

> > another analysis by researchers at the National Cancer Institute

> involving

> > more than 244,000 cancer patients nationwide found that could not

> explain

> > all the difference.

> >

> > " This is almost certainly related to a mix of factors across races

> > pertaining to tumor biology and inherited factors, " Albain said.

> >

> > Albain disputed suggestions the study could be used to support racial

> > prejudices.

> >

> > " We certainly aren't talking about 'genetic inferiority' or

> stereotypes in

> > our study (or implying it) and it would be a shame to have these

> results

> > misinterpreted by someone in this way, " Albain wrote in e-mail. " What

> we are

> > saying is that there is something that 'tracks' with African ancestry

> only

> > in these three diseases. . . . Once we discover the explanation for

> our

> > findings, tailored treatments will benefit all races. "

> >

> > But Brawley, who speaks widely on issues of racial disparity, and

> others

> > argued that access to high-quality care remains the dominant problem.

> > Socioeconomic factors that occur earlier in life may explain the

> findings,

> > Brawley said. For example, poor people and minorities are more likely

> to

> > grow up in polluted neighborhoods and have been hit hardest by the

> obesity

> > epidemic, which could lead to more difficult-to-treat cancers, he

> said.

> >

> > " These differences are not due to inherent genetics. They are due to

> the

> > effects of environmental factors like diet and exercise and obesity on

> > biology, " Brawley said.

> >

>