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Genes that Discriminate

“African-American men are discriminated against by prostate cancer, and for the first time, we know why.”  This was oncologist Jonathan Simons, M.D., CEO of the Prostate Cancer Foundation, talking to the Congressional Black Caucus at a special symposium on prostate cancer.

Simons was telling the lawmakers about the trailblazing work by scientists Kosj Yamoah, M.D., Ph.D., Edward Schaeffer, M.D., Ph.D., and colleagues, recently published in the Journal of Clinical Oncology.   These scientists have identified a few “terrorist genes” that particularly target men of African ancestry – and the good news from this bad discovery is that it may soon lead to a test “that could be like a smoke detector,” telling men years ahead of time that they have the potential for lethal cancer.  

The worst offender is a gene called NKX3-1.

“The Prostate Cancer Foundation funded this work, along with the Department of Defense,” Simons continued.  That study involved 154 patients, and a larger study – involving the biopsy tissue samples of at least 1,000 patients – is needed.  “But not one penny of this research was funded by the National Cancer Institute, the National Institutes of Health, or the American Cancer Society, because this idea was thought to be too risky, or too edgy.  The Federal government can’t find $5 million to fund research to extend and validate the study. ”     

Simons recalled something former Atlanta mayor Andrew Young – himself a prostate cancer survivor – once told him:  “Unequal access to research ideas is just as much a part of the problem as unequal access to care.”  

This research needs to be funded on a federal level.   “We must understand the NKX3-1 gene if we are going to understand why African-American men are dying of prostate cancer.”  This gene had been found in prostate cancer before, but had never been looked at carefully in men of European descent vs. men of African descent.  “There is a whole set of genes that are equal opportunity offenders in prostate cancer,” Simons explained. “The genes on this list – and it’s not a very big list – kill white men, too.  But they are activated earlier, and are disproportionately burdensome in African-American men.  It’s not an issue of race, just of the unfairness of life.”  

In the same way that people with red hair, blue eyes, and freckles are more likely to develop cystic fibrosis, and women of Ashkenazi Jewish heritage are more likely to have the BRCA1 gene that triggers breast and ovarian cancer, black men are more likely to develop aggressive prostate cancer, and to die of it.  

In addition to the NKX3-1 gene, a handful of other genes need to be studied.  “This is like a Most Wanted list,” Simons said.  “The difference is, this list is life-saving.”

Janet Worthington
Janet Farrar Worthington is an award-winning science writer and has written and edited numerous health publications and contributed to several other medical books. In addition to writing on medicine, Janet also writes about her family, her former life on a farm in Virginia, her desire to own more chickens, and whichever dog is eyeing the dinner dish.