How do stress and cortisol levels contribute to prostate cancer incidence and aggressiveness in Black men? Dr. Leanne Burnham explains her research studies where they looked specifically at the role of stress in prostate cancer, tumor aggressiveness, and Black men — and also shares research about cortisol levels in African American children.
Dr. Leanne Burnham
I have a few publications that look at the role of stress and prostate cancer, tumor aggressiveness, and Black men. And so, I looked at Black men specifically, because I have wondered if Black men who maybe were exposed to more stressors in their lifetime if that had any correlation to Black men getting prostate cancer earlier in their life and getting a more aggressive disease. And so, there were very realistic ways that we were able to look at that in the lab and then also in collaboration with public health colleagues that I have. Because what we know there are studies that show that African American children experience more stress, and their cortisol levels in their bodies are effective much earlier than any other race, and their studies that show the distress begins in the daycare setting based on discrimination that they may have from the adults that are taking care of them in that setting. And so, imagine cumulatively how that looks, and so we have ways that there are validated scales to assess levels of stressors that people have been exposed to. So that could be…what are your finances looking like? Have you been affected by incarceration yourself or anyone in your family? Have you experienced the death of a loved one? Has your home been broken into recently?
There are all kinds of, there are hundreds and hundreds of questions, and we can get to the root of how much stress has somebody been exposed to. And we know that unfortunately, African Americans in this country are exposed to more of these stressors than other demographics, and so what we did was look at the elevated stress, we could look at the cellular level and see, now if we’re growing prostate cancer cells, so that’s what I did. I was growing cancer cells in the lab that were from Black patients and white patients, and I would expose them to stress hormones in the flask, or maybe you like to think of it as kind of like a petri dish, but in the flask where the prostate cancer cells were growing. I would treat them with stress hormones, and then I would look and see do the cells grow differently, do they express genes and proteins differently based on race? And what I found very surprisingly, disturbingly, whichever adverb you want to use, that the African American prostate cancer cells, when they were exposed to stress hormones, the tumor cells became more aggressive, and they up-regulated genes that we know prime a patient to resist therapy.
So, the genes that were up-regulated in these prostate cancer cells are genes that we know, let’s say if a patient were to get chemotherapy, that patient would be more likely to fail that chemotherapy early, which is a terminology we call chemo resistance. And so those are studies right now that have just sort of, they’re newer to the forefront looking at stress and tumor aggressiveness. But there are studies going on nationwide right now involving thousands of African American men participants, where we are looking at the role of stress and what that does in terms of prostate cancer, aggressiveness in Black men specifically, and seeing what we can do to address it. But first we have to acknowledge that the problem is even there, a lot of people don’t think the problem is there, but we are scientists, we think the problem is there. So, we have to get the data to show the public that the problem is there, and then we need to really address the systemic racism that leads to this elevated and chronic stress that other demographics don’t have to deal with, because it’s literally leading to increased disease and increased health disparities. And if that’s something that we can change at some very basic levels, then that will improve health overall.