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Research from the National Cancer Institute tells us that African-American women are more likely to develop an aggressive form of breast cancer and die from it than are Caucasian women. The same can be said of African-American men with prostate cancer — clinical findings that are especially relevant in the Deep South.
Cancer researchers Seema and Ajay Singh, Ph.D.s, faculty members at USA Mitchell Cancer Institute, hypothesize that there may be more to racial disparities in cancer than just the socioeconomic factors, such as a lack of access to medical care. They are exploring what’s going on at the molecular level.
Seema Singh is researching the tumor “microenvironment” in breast cancer of African-American women in a study funded recently by a $1.7 million grant from the National Institutes of Health. Ajay Singh’s research, funded by a $1.57 million NIH grant awarded in 2014, has identified a protein that is more prevalent in prostate cancer for African- American men.
“In Alabama, this is a hot topic,” says Seema Singh, associate professor of oncologic sciences. “We know that there are many factors at work, such as access to health care. However, we believe that not only those factors, but also biological factors, play a role.”
Seema Singh is studying cytokines, which are cell-signaling molecules that help in cell-to-cell communication. Tumor cells alter the levels of cytokines they secrete, which influences the surrounding environment. As a result, a patient’s defense system, which is supposed to eliminate tumor cells or restrict tumor growth, starts aiding in tumor cell growth in a process referred to as “hijacking the host.”
Seema Singh’s team will examine the differential levels of these cytokines in blood and tumor samples from African-American and Caucasian women as a part of the five-year study. Moreover, she will study how these cytokines affect tumor cells and the surrounding tumor microenvironment to support the aggressive growth of breast cancer. “We expect to prove that the higher levels of these cytokines are an important reason for the existence of aggressive breast tumors in African-American women and why minority patients often respond poorly to chemotherapy,” she says.
Ajay Singh, professor of oncologic sciences, and his team have identified a protein called MYB that is found at a higher level in prostate cancer for African-American men than for their European-American counterparts. As part of his NIH-funded research, he plans to establish the role of this protein in aggressive and therapy-resistant prostate cancer that afflicts mostly minority patients. He also plans to gauge the clinical significance of the protein levels to establish MYB as a method for distinguishing aggressive tumors from ones that are less aggressive.
“High PSA levels in patients are currently considered a marker for the presence of prostate cancer. However, it has been realized lately that not all patients with high PSA will develop prostate cancer or the type of cancer that should be of clinical concern,” he says. “So in some cases, there is an over-diagnosis of cancer, but PSA is the only test available right now.”
Eventually, he says, the findings from his study could pave the way for a marker that would be more efficient than PSA. Also, his research could help in the development of effective therapies or prevention strategies to reduce the widening gaps in clinical outcomes of patients with different racial backgrounds.
Ajay Singh heads the Health Disparities in Cancer Research Program at MCI. The program also includes Seema Singh; Rodney P. Rocconi, M.D., associate director for clinical research, and Margaret Sullivan, associate director for cancer control and prevention.
Many complex and interrelated factors contribute to disparities in cancer incidence and death among racial, ethnic and underserved groups, Sullivan says.
“The most obvious factors are associated with a lack of health care coverage and low socioeconomic status, but many relate to genetic and molecular differences that our Health Disparities in Cancer Research Program is addressing,” she says. “Together with our cancer control and outreach efforts, we can launch community-based awareness programs and assess socioeconomic, environmental and cultural factors that may contribute to health disparities, in addition to the basic research under way.”
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