In general men from Asian ethnic groups are less likely to die of prostate cancer compared to men from European or African ethnic groups. Studies from individual Asian countries have established that generally, Asian men have a better baseline metabolic profile compared to Caucasian prostate cancer patients. Several studies have shown, for example, that Asian men are less likely to have severe cardiac events on ADT and may be able to tolerate multiple rounds of chemotherapy with less toxicity than those of Caucasian background.
Note though that in the last paragraph we mention studies from individual Asian countries. How broad reaching are these ethnic generalizations?
There's a new study that looks at the adverse metabolic responses to ADT for men from several Asian countries. The study followed 589 patients for a year or more from Hong Kong, the People's Republic of China, Taiwan, and Malaysia. The average age of the men was 72 years.
Within six months, the men showed significant increases in fasting glucose levels and in hemoglobin A1c indicative of increased risk of diabetes. Similarly, their triglyceride levels were elevated and on average they gained 1 kilogram in weight within a year and a half of starting on ADT. These are common signs of metabolic syndrome seen in men on ADT from European and African ethnic groups.
The Asian patients thus show similar metabolic shifts to those seen in men from other continents and ethnicities, although not quite as severe. The Asian men in general are not as likely to be overweight as, say, North American prostate cancer patients and that may account substantially for the Asian men doing better on ADT.
Large population studies of health and ethnicity, like this one, will be increasingly important as we learn more about the genetics of prostate cancer progression. Studies like this can help us find genetic biomarkers of disease development and hopefully identify treatments that are most effective for men of diverse genetic backgrounds.
Reference:
Wong, C., Xu, N., Lim, J., Feng, K., Chan, W., Chan, M., Leung, S., Chen, D., Lin, Y., Chiu, P., Yee, C., Teoh, J., Huang, C., Yeoh, W., Ong, T., Wei, Y., & Ng, C. (2023). Adverse metabolic consequences of androgen deprivation therapy (ADT) on Asian patients with prostate cancer: Primary results from the real-life experience of ADT in Asia (READT) study. The Prostate, 10.1002/pros.24519.