Quality of care, other issues may cause worse results in black prostate cancer surgery patients

May 15, 2012

Black prostate cancer patients may not be getting the same quality of care as white patients, according to a first-of-its-kind study by researchers at Henry Ford Hospital who found racial disparities in the results of surgery to remove diseased prostates.

While it is possible that anatomical differences or may explain why the results of radical are not as good for African Americans as for white undergoing the same procedure, the study concluded that "surgeons, administrators and need to implement measures to address these disparities."

The new , based on population samples from throughout the U.S., will be presented this week at the American Urological Association's Annual Meeting in Atlanta.

Quoc-Dien Trinh, M.D., a Fellow at Henry Ford Hospital's Vattikuti Urology Institute and lead author of the study, says that while no one before has reported in the results of , earlier studies have found similar differences in other areas of medical treatment and care.

"Again, research raises a serious issue in the difference between Caucasian and , and we're trying to understand why it is happening," Dr. Trinh says.

"Is it a biological issue? African American patients might present with worse disease, therefore surgery and treatment are more difficult. For some cancers, like pancreatic, if you have worse disease, the surgery is harder. But that's doubtful with . It shouldn't be the case."

Dr. Trinh also notes that it is possible that African American patients have an anatomical difference – the form of their pelvis – that makes their surgeries harder, and there are studies to support that. "It's not controversial, just related to bone structure. And it might, big question mark, might make surgery harder," he says.

"But if it's not anatomy or a disease aggressiveness issue then why do Caucasians have a better outcome than African American patients? While this study does not go into those specific issues, it raises the question."

Using the most recent available data from the Nationwide Inpatient Sample (NIS), Dr. Trinh and his fellow researchers identified 7,408 African American and 51,319 white prostate cancer patients who underwent (RP) between 2001 and 2007. In RP, the entire cancerous prostate and some surrounding tissue are surgically removed.

They then compared the surgery's immediate and short-term outcome, according to race, in five areas: rates of blood transfusions, complications during and after surgery, prolonged hospital stay, and in-hospital death. They found that compared to their white counterparts, African American patients had:

  • Significantly higher rates of blood transfusions, 9 percent compared to 6 percent
  • More complications during surgery, 1.7 percent compared to 1.3 percent
  • Higher rates of overall complications after surgery, 13 percent vs. 10.3 percent
  • Longer hospital stays (more than the median 3 days), 28.7 percent vs. 20.9 percent
  • No differences for in-hospital mortality rates

Trinh says because of limitations on available data, there is no way to know exactly why these disparities exist yet. "Is it physician and patient interaction, types of insurance, how these patients are perceived? It's hard to know," he says.

"I'd say that it's a little bit of everything – worse disease, presentation, anatomy that makes surgery harder. But it's also a question of quality of care for ethnic minorities, especially in the American health care system. And that needs to be raised."

Explore further: Prostate cancer surgery better at teaching hospitals

Related Stories

Prostate cancer surgery better at teaching hospitals

November 7, 2011
Prostate cancer patients who undergo radical prostatectomy get better results at teaching hospitals than at non-academic medical institutions, according to the findings of an international study led by researchers at Henry ...

Women fare better than men, but need more blood after kidney cancer surgery

May 15, 2012
Women do better than men after surgical removal of part or all of a cancerous kidney, with fewer post-operative complications, including dying in the hospital, although they are more likely to receive blood transfusions related ...

Fewer prostate cancer surgery complications found in teaching hospitals with fellowship programs

May 15, 2012
Patients who undergo radical surgery for prostate cancer may expect better results, on average, if they're treated in accredited teaching hospitals with residency programs, and better still if the hospitals also have medical ...

Fewer complications, better outcomes with robot-assisted prostate cancer surgery

April 24, 2012
Robot-assisted surgery is now both more common and far more successful than radical "open" surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue ...

Higher hospital volume more important than surgeon experience in outcome of prostate cancer surgery

May 15, 2012
Older, sicker, high-risk patients who undergo one of the most common treatments for prostate cancer get better results in larger, busier hospitals, according to new research by Henry Ford Hospital.

Safer kidney cancer surgery under-used for poorer, sicker Medicare, Medicaid patients

May 15, 2012
An increasingly common and safer type of surgery for kidney cancer is not as likely to be used for older, sicker and poorer patients who are uninsured or rely on Medicare or Medicaid for their health care, according to a ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.