Biomarkers for Metastatic Prostate Cancer Risk in Black Men Pinpointed

Key Points

• Men of West African heritage are more likely to have diabetes and prostate cancer than men of other races and ethnicities. Black men are also more likely to die of both conditions.
• Researchers investigated whether specific biomarkers may be involved in diabetes and metastatic prostate cancer progression.
• They identified four new biomarkers that may be used to develop more inclusive, effective tools to assess patients' risk of advanced cancer and lead to alternative treatment.

A distinct cell metabolism process may raise the risk of diabetes and metastatic prostate cancer in men of West African descent, according to a recent research trial. The findings could eventually lead to better testing methods and an alternative treatment for prostate cancer tailored to Black men with both conditions.

Researchers presented the study—its findings need much more research at this point—at the 2023 American Chemical Society conference.

How common are diabetes and prostate cancer in Black men?

Black men are 60 percent more likely to be diagnosed with diabetes and almost twice as likely to die from the disease than non-Hispanic white men, according to the U.S. Department of Health and Human Services Office of Minority Health.

They're about 70 percent more likely to be diagnosed with prostate cancer and two to four times more likely to die because of it compared to other racial and ethnic groups, according to the American Cancer Society (ACS).

The five-year relative survival rate for people with prostate cancer is greater than 99 percent when the disease is diagnosed and treated early, in the localized stage. However, when it metastasizes or spreads to distant body parts, the five-year relative survival rate drops to 32 percent, per the ACS. Even with that result, the overall five-year relative survival rate is 97.3.

Men with diabetes, especially Black men, are much more likely to develop metastatic cancer, said Sarah Shuck, Ph.D., the study's lead investigator and an assistant professor at the Arthur Riggs Diabetes & Metabolism Institute with City of Hope in Duarte, California.

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What's the link between diabetes and metastatic prostate cancer?

Researchers at City of Hope have established a causal link between metabolic dysregulation and associated cellular abnormalities, diabetes and metastatic prostate cancer, according to a news release.

In this study, Shuck and her colleagues sought to find how four biomarkers related to methylglyoxal (MG) may be involved in metastatic prostate cancer and whether these biomarkers were also connected to race.

Levels of MG, a highly reactive compound, tend to be higher in people with diabetes, Shuck said. It's also associated with tumor growth.

MG, a byproduct of lipid, protein and glucose metabolism, bonds with RNA, DNA and protein. In doing so, it can create complexes that mutate DNA and disrupt cells' stability and functionality, which may lead to cancer.

Cells use glyoxalase 1 (GLO1) to detoxify and prevent malignancy. A genetic variation in GLO1 was among the biomarkers researchers investigated.

What did researchers discover while testing for MG levels?

Researchers collected blood samples from 371 men across the United States, some with prostate cancer and others without, and then checked the samples for genetic evidence of West African heritage.

The collection methods were developed by Rick Kittles, Ph.D., a professor of cancer biology at the University of Arizona College of Medicine in Tucson, and Leanne Woods-Burnham, Ph.D., an assistant professor at the Morehouse School of Medicine in Atlanta.

Shuck and her team initially hypothesized MG levels would be higher in Black men with metastatic prostate cancer, per the release. However, they found the opposite to be true. Men of West African heritage had fewer MG complexes in their blood, and lower levels of MG correlated with a greater risk of metastatic disease. The same wasn't true in men of European descent.

The researchers believe that's because, in Black men, the MG complexes are confined within tumor cells rather than circulating in the blood, so they promote tumor growth from within, Shuck said.

Variations in the GLO1 gene may play a role.

Previous research has demonstrated similar findings in triple-negative breast cancer, an aggressive, frequently recurring form of breast cancer that disproportionately affects Black women, Shuck said.

What's next for researchers?

Shuck and her cohorts hope the findings can become part of a comprehensive clinical panel that can be used to predict the risk of metastatic prostate cancer.

"Specifically, we anticipate that these tools can be used to determine which men with diabetes are at the highest risk of metastatic prostate cancer," she said. "The goal is to give physicians the ability to determine which men will respond best to specialized treatments and potentially identify new therapeutic targets."