Racial and Ethnic Disparities Common in Treatment of Rare Cancer

By now it’s become common knowledge that Americans of color face severe disparities in incidence rates, treatment and survival when it comes to the most common types of cancer—e.g., cancers of the breast, lung, prostate and colon. But what’s less well known is how racial and ethnic minority populations are affected by rarer, less common forms of the disease. Now, however, cancer researchers are beginning to turn their attention to this question. And they’re finding that here, too, the playing field is far from level.

A first-of-its-kind study conducted by researchers in California has found that significant racial and ethnic differences exist in the treatment and outcomes of patients with extremity soft-tissue sarcomas, a rare but dangerous cancer that begins in muscle, fat, blood vessels or other supporting tissue of the body. While the disease can sometimes lead to amputation of the affected arm or leg, the standard treatment is a combination of radiation therapy and limb-preserving surgery. In fact, in about 90% of cases, patients can be treated effectively without having to lose their limb.

However, the study’s findings, published in the March 1 issue of the American Cancer Society’s journal CANCER, reveal that amputation is much more likely to be physicians’ treatment of choice when patients are African American or Hispanic. Black patients in particular had significantly lower rates of limb-saving surgeries compared to other racial/ethnic groups, had the highest rates of amputation and were least likely to receive additional treatments that would lead to improved survival. As a result, black patients were 39% more likely to die from their disease than their white counterparts.

The researchers, led by Dr. Steve Martinez of the University of California Davis Cancer Center, also found that Hispanics tend to be diagnosed with extremity soft-tissue sarcomas at a younger age than other ethnic groups, and that African Americans, Hispanics and Asians tended to have larger tumors than Caucasians. “[The medical profession] needs to focus our efforts toward improving extremity soft-tissue sarcoma treatment and outcomes for all patients, especially for those most at risk,” Martinez concludes.