The association of diabetes and obesity with prostate cancer aggressiveness among Black Americans and White Americans in a population-based study

PURPOSE: Few studies have investigated the role of race in the association of diabetes and obesity with prostate cancer aggressiveness. Here we evaluate the independent association between diabetes and obesity with prostate cancer aggressiveness in White Americans and Black Americans. METHODS: Our cross-sectional, case-only study consisted of 1058 White Americans and 991 Black Americans from the North Carolina-Louisiana Prostate Cancer (PCaP) project. Diabetes status was determined by self-report. Obesity was determined using body mass index and calculated based on anthropometric measurements. High aggressive prostate cancer was defined as Gleason sum ≥8, or prostate specific antigen >20 ng/ml, or Gleason sum =7 and clinical stage cT3-cT4. The association between diabetes and obesity with high aggressive prostate cancer at diagnosis was evaluated using multivariable logistic regression and adjusted for potential confounders. RESULTS: Diabetes was not associated with high aggressive prostate cancer in the overall sample (OR: 1.04; 95% CI: 0.79, 1.37), White Americans (OR: 1.00; 95% CI: 0.65, 1.57), or Black Americans (OR: 1.07; 95% CI: 0.75, 1.53). Obesity, independent of diabetes, was positively associated with high aggressive prostate cancer in White Americans (OR: 1.98; 95% CI: 1.14, 3.43), but not in the overall sample (OR: 1.37; 95% CI: 0.99, 1.92) or Black Americans (OR: 1.09; 95% CI: 0.71, 1.67). CONCLUSIONS: Diabetes was not associated with prostate cancer aggressiveness, overall, or in either race-group. Obesity, independent of diabetes, was associated with high aggressive prostate cancer only in White Americans

Advancing breast cancer survivorship among African-American women

PURPOSE: Advances have occurred in breast cancer survivorship but, for many African American women, challenges and gaps in relevant information remain. METHODS: This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African American women. RESULTS: For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. CONCLUSIONS: There is a need for a better understanding of breast cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American breast cancer survivors are desirable