Study of Prostate Cancer in Black and White U.S. Veterans

Primary Objectives: To evaluate the relationship between the length of the CAG repeat sequence occurring in the androgen receptor gene and major prostate cancer prognostic determinants (race, age, histologic grade and stage) at the time of diagnosis in black and white veterans.

Secondary Objectives: To create a secure, organized bank of DNA plasma samples obtained from newly diagnosed prostate cancer patients and assay the peripheral blood DNA for inherited polymorphisms of the androgen receptor gene.

Primary Outcomes: The primary outcomes are androgen receptor CAG repeat sequence length and stage of disease.

Intervention: N/A

Study Abstract: Prostate cancer is diagnosed in approximately 334,500 men each year and accounts for nearly 41,800 deaths in the United States. Prostate cancer is the leading cancer affecting veterans and the second leading cancer among all Americans. The causes of prostate cancer and, particularly, the reasons for the unusually high incidence rates in African-Americans remain obscure. Dietary factors likely play a role in fatal cases, while hormones are also important in regulating prostate cancer growth. Dr. Charles Huggins recognized this effect in the 1940's, with androgen deprivation remaining as the cornerstone of therapy for advanced disease. Despite the strong circumstantial evidence, neither epidemiologic studies nor basic sciences have produced clear insight into the etiologic role of hormones. However, recent observations regarding androgen receptor gene polymorphisms and their relation to endocrine expression and prostate cancer risk may be providing important clues as to how an etiologic role might be mediated at the molecular level. Thus, it is important to attempt to identify genetic markers of high-risk cancer patients for necessary screening and counseling efforts.