A US-based Ghanaian medical research scientist has asked Ghanaians and Africans living on and off the continent to be more aware of their health, asking that they pay more attention to their lifestyles to modulate their risk to cancer because cancer is no more a disease of the West.
Dr. Bernard Kwabi-Addo is a cancer research biologist and an Associate Professor of Biochemistry at Howard University in Washington D.C. where he talked about the research he is conducting on cancer risks, particularly in individuals of African ancestry. He also talks about his findings and recommends preventative measures.
“I joined Howard University in 2007 after completion of my post-doctoral research training because I felt this historically black institution will give me a greater opportunity to conduct more research on Africans and African Americans as we seek to discover better ways of attacking the disease among the world’s black communities,” says Dr. Kwabi-Addo.
Dr. Addo completed a Bachelor of Science degree in Biochemistry at the University of Dundee in Scotland and a Master of Science in Molecular Biology and Biotechnology at the University College London in the UK where he worked for a year at the Medical Research Council in Cambridge prior to embarking on a Ph.D. research program at the University of London.
After completing his Ph.D. work in Molecular Biology, he came to the USA for a post-doctoral fellowship in the laboratory of Professor Michael Ittmann at Baylor College of Medicine in Houston, Texas where he studied the molecular mechanisms underlying prostate carcinogenesis. His work in Prof. Ittmann’s laboratory really inspired him to look more into cancer in ways that will assist sufferers of the disease with particular interest in people of the black race.
As he says, “in comparison to the past century, these are very exciting times to do cancer research because we are now understanding a lot more about the causes of cancer, the factors associated with its etiology and or progression. For some types of cancers such as Colorectal cancer, we know that the predominant risk factors are environmental factors and lifestyle choices: for instance, epidemiological studies have demonstrated that a diet rich in red meat and highly processed foods, combined with a sedentary lifestyle is significantly associated with Colorectal cancer”.
On the other hand, diets rich in fruits and vegetables and modest exercise has proven to significantly reduce the risk of Colorectal cancer. Other cancers, such as prostate cancer has a strong genetic component Dr. Kwabi-Addo says.
Individuals who come from a family with a history of an affected male relative have increased the risk of prostate cancer compared to individuals with no such family history. Through genetic studies, “we have identified several genes that may be associated with the disease etiology and or progression of prostate cancer and this is helping us to design better markers for early detection of the disease when there is a good chance for a cure and such studies would ultimately lead to new therapeutic interventions”.
When asked about how his interest in cancer begun, Dr. Addo reveals: “an aunt of mine was diagnosed with breast cancer in the late 1980s, a time when little was known about the disease particularly in Ghana. Even though my auntie had a mastectomy, she eventually succumbed to the disease because we were unable to afford several medications that might have helped her and this really was the impetus for my pursuit of cancer research.”
This rather unfortunate incident made the doctor decide to study breast and prostate cancers because they are major public health concerns not only in the US but globally. Both cancers share a lot in common as some studies have reported a common etiology by observing a high incidence of prostate cancer among men in geographic regions where breast cancer is also common. These 2 organs are hormone-dependent; breast tissues are dependent on estrogen and prostate tissues is androgen-dependent.
“My research focus is primarily investigating the molecular mechanisms underlying prostate cancer etiology and progression. I carry out a lot of Deoxyribonucleic acids (DNA) analysis: looking for mutations, deletions and other genetic changes that can alter gene expression and contribute to carcinogenesis. In addition, I study another phenomenon known as epigenetic changes such as DNA methylation changes and how these alterations contribute to prostate cancer disparity” explains Dr. Kwabi-Addo.
Speaking on his research findings, the doctor says his laboratory is focused on finding novel biomarkers for cancer detection. The current screening tools for breast and prostate cancers are namely, mammography and Prostate Specific Antigen (PSA) screening respectively. The PSA is not specific to prostate cancer. Indeed if you have benign prostatic hyperplasia a condition that causes encouragement of the prostate that is common in older men of 60+ there is some form of infection causing prostatitis, increasing PSA levels and creating problems with the sensitivity and specificity of using PSA screening for prostate cancer tissues.
“We, therefore, need other markers that can be used perhaps in conjunction with the current PSA screening. Another issue is that the PSA threshold is different for African American and Caucasian men. Therefore, there is a need for a more “ethnic sensitive” marker for the disease’s detection. My work investigating the DNA methylation pattern in prostate tissue samples from both races has identified several genes that show differential methylation patterns in these 2 groups with varying sensitivity and specificity for each group. We are therefore pursuing this angle of research in a large population-based setting.”
Another area of scientific interest to Dr. Kwabi-Addo is cancer prevention. The American Cancer Society predicts that 1 in 2 men and 1 in 3 women will be diagnosed with cancer in their lifetime. What is causing this alarming rate of cancer incidenc — aging. Cancer is mostly detected in people over the age of 60 years and for the first time in modern history, we are living longer than our predecessors so we will find increase cancer incidence. We also know that our environment is changing our diet and lifestyle due to urbanization.
Unfortunately, these changes are causing harm to our DNA, thus anything that can potentially affect your DNA can lead to cancer. However, less than 10% of genetic mutations underlie hereditary or familial predisposition to cancer. Thus the majority causes of cancer are environmental exposures and how these interact with our genes. These and other issues related to this topic are thoroughly explained in a book entitled “Cancer causes and controversies — understanding risk reduction and prevention” written by Dr. Bernard Kwabi-Addo with Tia Laura Lindstrom. This book is available in hard or paperback at Amazon.com
Besides his book, Dr. Kwabi-Addo and his collaborators have published several scientific articles in peer-reviewed journals reporting genetic and epigenetic alterations that underlie breast and prostate carcinogenesis and the disease disparities. They are actively pursuing several genes they’ve identified from studies as biomarkers for disease detection.
On the downside, a major challenge faced in cancer research, according to Dr. Kwabi-Addo is that the molecular basis of both breast and prostate cancer is heterogeneous, meaning that there are multiple genetic factors that can cause each disease. For example, there are sub-types of breast cancer such that one individual or individuals belonging to one ethnic group may be more susceptible to one particular subtype of breast cancer compared to another individual or ethnic group.
The good news is that the completion of the human genome project now makes it possible to generate a molecular profile for each cancer patient to specifically target treatment; this is ultimately paving the way for precision or personalized medicine. This excites Dr. Addo who says his “long-term research goal is to elucidate the molecular mechanisms underlying cancer disparities and to design more ‘ethnic sensitive’ markers for the disease detection.”
It has become important for Ghana and African researchers in cancer to work on discovering avenues of treatments that work better for people of that race and to also remove the stigma and dread attached to all forms of cancer to enable people speak more about their conditions, take necessary pre-cancer tests and begin working in communities to promote cancer prevention.
Written by Oral Ofori