Monitoring early stage prostate cancer instead of treating it may not be appropriate for all patients, especially black men, a new study indicates

According to background information with the study, there is currently controversy among oncologists over the best way to handle early stage prostate cancer, with some experts suggesting that regular monitoring — known as watchful waiting — of the disease is the best approach because it avoids over-treatment. But this new study suggests that watchful waiting may not be suitable for all men with early stage prostate cancer, especially black patients. “We know that African-American men have more aggressive prostate cancer than Caucasian men,” Dr. Kosj Yamoah, chief resident in the department of radiation oncology at Thomas Jefferson University in Philadelphia, said. “Our study shows that African-American men who are diagnosed with a low-grade cancer at first — the cancers that are sometimes watched rather than treated — are more likely to develop aggressive disease sooner than Caucasian men,” he said. The researchers analyzed the medical records of men who were confirmed to have low-grade prostate cancer and had surgery to remove part or all of their prostate. Among these patients, blacks were more likely to have cancer progression and worse outcomes than whites. Seven years after surgery, rates of disease control were 90% among whites and 79% among blacks, the study found. The researchers are still searching for molecular clues that would help identify black prostate cancer patients who have the highest risk of disease progression and those most likely to benefit from watchful waiting.