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NEW YORK, Oct. 5 /PRNewswire/ -- According to a report from San Francisco General Hospital, low-income men are more likely to have advanced prostate cancer compared to their financially secure peers. "As of right now, the reason behind this statistic is not because of a lack of access to quality medical care since many of the study's patients had had routine prostate cancer screening," said Dr. David Samadi, Chief of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine in New York City, a urologic oncologist specializing in prostate cancer treatment and robotic surgery using the da Vinci surgical system.



Racial differences in the low-income group do not account for the disparity, despite the fact that the hospital had a large percentage of African-Americans in their study group. African-American men are typically at a higher risk of prostate cancer than other racial groups. Researchers of the study from this publicly funded "safety net" hospital, which sees mostly low-income and uninsured patients, believes many factors are contributing to the elevated number of high-risk prostate cancer cases. Risk factors such as obesity, diet or environmental issues might also be playing a part even though science has not completely determined a true link between these issues and prostate cancer. "What is at work here is some unidentified genetic factor that is affecting prostate cancer progression in this specific group," said Dr. Samadi.

Researchers speculated that the stress of living in poverty could be affecting the numbers. Previous studies with animals showed that chronic stress could negatively impact the immune system, which would, in turn, affect the progression of prostate cancer. "But this link between stress and immunity has also never been proven," said Dr. Samadi, a robotic surgeon with over 3,000 successful robotic prostatectomies to his credit, "More research is needed confirm these results in other public hospitals and to try to discover the true reasons behind the theory."

Routine prostate cancer screening is controversial because of general public perception of the overtreatment of prostate cancer. A recent U.S. study estimated that prostate cancer screening resulted in more than 1 million men being diagnosed with tumors that would never have caused any serious problems. "The reasoning behind this perception is that prostate cancer tumors are usually slow growing and the screening detects mostly small, low-risk tumors that get treated even though the tumors may not have caused any problems," explained Dr. Samadi.

Since the resulting side effects like erectile dysfunction and incontinence are not worth the risks for low-risk prostate cancer, low-income men are then forced to opt against prostate cancer treatment and instead merely monitor the cancer's progression. "A robotic prostatectomy cures the cancer and significantly reduce the side effects but the real issue here is that PSA screening might be more beneficial for low-income men," said Dr. Samadi, "It would be better to step up targeted screening efforts in public hospitals, instead of academic medical centers."

"The study emphasizes public assistance healthcare program issues and the challenges and opportunities that they encounter in reducing 'cancer-related socioeconomic disparities'," explained Dr. Samadi. Samadi believes that improving access to prostate cancer screening and treatment will greatly reduce the prostate cancer disparities seen in poor and minority regions, stating, "These men need more comprehensive healthcare strategies to eradicate the disparities in prostate cancer dangers and death."

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