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Ogunsanya ME, Kaninjing E, Ellis TN, Bamidele OO, Morton DJ, McIntosh AG, Dickey SL, Kendzor DE, Dwyer K, Young ME, Odedina FT. Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach. J Cancer Surviv 2024:10.1007/s11764-024-01619-x. [PMID: 38805150 DOI: 10.1007/s11764-024-01619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. METHODS In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. RESULTS Participants were thirty-four men aged 49-84 years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. CONCLUSION The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. IMPLICATIONS FOR CANCER SURVIVORS Black CAP survivors experience significant burdens and challenges that impact their overall quality of life. Understanding the factors that impact the complex survivorship journey can inform design and implementation of interventions to address the multiple challenges and thus improve quality of life.
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Affiliation(s)
- Motolani E Ogunsanya
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
| | - Ernest Kaninjing
- School of Health and Human Performance, Georgia College & State University, Milledgeville, GA, USA
| | - Tanara N Ellis
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
| | - Olufikayo O Bamidele
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
| | - Daniel J Morton
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Andrew G McIntosh
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sabrina L Dickey
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kathleen Dwyer
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- OU Health Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Mary Ellen Young
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
| | - Folakemi T Odedina
- Prevention, Symptom Control and Survivorship, and Care Delivery Transformation (CPSD) Program, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Jacksonville, FL, USA
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Khan S, Fuzzell L, Langston M, Han Y, Moore JX, Gilbert K, Sutcliffe S, Bensen JT, Mohler JL, Fontham ETH, Song L, Lewis-Thames MW. The impact of marital status on tumor aggressiveness, treatment, and screening among black and white men diagnosed with prostate cancer. Cancer Causes Control 2024; 35:531-539. [PMID: 37919455 DOI: 10.1007/s10552-023-01821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/27/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE To examine the association of marital status with prostate cancer outcomes in a racially-diverse cohort. METHODS The study population consisted of men (1010 Black; 1070 White) with incident prostate cancer from the baseline North Carolina-Louisiana Prostate Cancer (PCaP) cohort. Marital status at time of diagnosis and screening history were determined by self-report. The binary measure of marital status was defined as married (including living as married) vs. not married (never married, divorced/separated, or widowed). High-aggressive tumors were defined using a composite measure of PSA, Gleason Score, and stage. Definitive treatment was defined as receipt of radical prostatectomy or radiation. Multivariable logistic regression was used to examine the association of marital status with (1) high-aggressive tumors, (2) receipt of definitive treatment, and (3) screening history among Black and White men with prostate cancer. RESULTS Black men were less likely to be married than White men (68.1% vs. 83.6%). Not being married (vs. married) was associated with increased odds of high-aggressive tumors in the overall study population (adjusted Odds Ratio (aOR): 1.56; 95% Confidence Interval (CI): 1.20-2.02) and both Black and White men in race-stratified analyses. Unmarried men were less likely to receive definitive treatment in the overall study population (aOR: 0.68; 95% CI: 0.54-0.85). In race-stratified analyses, unmarried Black men were less likely to receive definitive treatment. Both unmarried Black and White men were less likely to have a history of prostate cancer screening than married men. CONCLUSION Lower rates of marriage among Black men might signal decreased support for treatment decision-making, symptom management, and caregiver support which could potentially contribute to prostate cancer disparities.
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Affiliation(s)
- Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA.
- Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Blvd., 7th floor, Newark, DE, 19713, USA.
| | - Lindsay Fuzzell
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr. MRC-COEE, Tampa, FL, 33612, USA
| | - Marvin Langston
- Department of Epidemiology and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
| | - Justin X Moore
- Center for Health Equity Transformation, Department of Behavioral Science, Department of Internal Medicine, Markey Cancer Center, University of Kentucky College of Medicine, 760 Press Avenue, Lexington, KY, 40536, USA
| | - Keon Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, St. Louis, University, 3545 Lafayette Ave., Room 316, St. Louis, MO, 63103, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
- Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, 4921 Parkview Place, St. Louis, MO, 63110, USA
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 3130 Bioinformatics Building, CB# 7295, Chapel Hill, NC, 27599, USA
| | - James L Mohler
- Roswell Park Comprehensive Cancer Center, Elm and Carlton St, Buffalo, NY, 14263, USA
| | - Elizabeth T H Fontham
- Department of Epidemiology, School of Public Health, Louisiana State University, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Lixin Song
- School of Nursing, University of North Carolina - Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | - Marquita W Lewis-Thames
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr, Chicago, IL, 60611, USA
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Ogunsanya M, Kaninjing E, Ellis T, Bamidele O, Morton D, McIntosh A, Dickey S, Kendzor D, Dwyer K, Young ME, Odedina F. Quality of Life Assessment Among Ethnically Diverse Black Prostate Cancer Survivors: A Constructivist Grounded Theory Approach. RESEARCH SQUARE 2024:rs.3.rs-3941497. [PMID: 38464107 PMCID: PMC10925397 DOI: 10.21203/rs.3.rs-3941497/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the US, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. Methods In-depth interviews were conducted with 34 participants: Native-born BM (NBBM) (n=17), African-born BM (ABBM) (n=11), and Caribbean-born BM (CBBM) (n=6) CaP survivors recruited through QR-code embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the US. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Results Participants were thirty-four men aged 49-84 years (mean±SD, 66±8). Most were married (77%), likely to be diagnosed at Stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. Conclusion The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices.
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Rana B, Okere UC, Imm KR, Yang L, Housten AJ. Physical activity behaviour change in black prostate cancer survivors: a qualitative study using the Behaviour Change Wheel. Support Care Cancer 2024; 32:154. [PMID: 38340207 DOI: 10.1007/s00520-024-08334-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Black individuals have a higher cancer burden and face greater obstacles to access cancer care resources when compared to White individuals. Radical prostatectomy is the standard surgical treatment and a common treatment option for prostate cancer; however, when compared to their White counterparts, Black individuals treated for prostate cancer often experience higher treatment-related side effects, resulting in a difficult recovery period. Physical activity is effective in alleviating treatment-related side effects; however, little is known about the barriers and facilitators to physical activity experienced by Black individuals after surgical management of prostate cancer to inform the design of physical activity interventions. METHODS Twelve Black individuals underwent radical prostatectomy for prostate cancer participated in a focus group study. We used the Behaviour Change Wheel, which incorporates Capability, Opportunity, Behaviour (COM-B) model and the complementary Theoretical Domains Framework (TDF), as our guiding theoretical framework. Data was analyzed using deductive qualitative analysis. RESULTS Facilitators and barriers were identified for all components of the Behaviour Change Wheel. Capability appeared to be a central factor to how participants described their physical activity engagement. Opportunity and motivation were described as both barriers and facilitators for behaviour change when occurring in isolation; however, when co-occurring with the presence of capability, they were described as facilitators that influence participants' physical activity engagement. CONCLUSIONS Our results demonstrate barriers and facilitators that are recognized among Black individuals who have undergone radical prostatectomy for prostate cancer. The design of a physical activity intervention needs to consider the physical and psychological capabilities as the fundamental basis with the additional support of physical activity opportunity and motivation. IMPLICATIONS FOR CANCER SURVIVORS Intersectionality across capability, opportunity, and motivation is essential to intervention design and development to increase physical activity in Black individuals surgically treated for prostate cancer.
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Affiliation(s)
- Benny Rana
- Cancer Epidemiology and Prevention Research, Alberta Health Services - Cancer Care Alberta, Calgary, AB, Canada
| | - Uzoma C Okere
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Kellie R Imm
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services - Cancer Care Alberta, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ashley J Housten
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
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Salifu Y, Almack K, Caswell G. 'Out of the frying pan into the fire': a qualitative study of the impact on masculinity for men living with advanced prostate cancer. Palliat Care Soc Pract 2023; 17:26323524231176829. [PMID: 37266393 PMCID: PMC10230602 DOI: 10.1177/26323524231176829] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023] Open
Abstract
Background Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men's experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men's experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context. Objective To explore how advanced prostate cancer impacts on men's masculine identity from the perspective of patients and their caregivers. Methods A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the 'frying pan into the fire'. Conclusion This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men's masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.
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Affiliation(s)
| | - Kathryn Almack
- Professor of Family Lives and Care, Centre for
Future Societies Research Communities, Young People and Family Lives Centre
for Research in Public Health and Community Care, School of Health and
Social Work, University of Hertfordshire, Hatfield, UK
| | - Glenys Caswell
- Independent Social Researcher and Death Studies
Scholar, Nottigham, UK
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Bamidele OO, Alexis O, Ogunsanya M, Greenley S, Worsley A, Mitchell ED. Barriers and facilitators to accessing and utilising post-treatment psychosocial support by Black men treated for prostate cancer-a systematic review and qualitative synthesis. Support Care Cancer 2022; 30:3665-3690. [PMID: 34982226 PMCID: PMC8724231 DOI: 10.1007/s00520-021-06716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To synthesise findings from published studies on barriers and facilitators to Black men accessing and utilising post-treatment psychosocial support after prostate cancer (CaP) treatment. METHODS Searches of Medline, Embase, PsycInfo, Cochrane Database of Systematic Reviews and Central, CINAHL plus and Scopus were undertaken from inception to May 2021. English language studies involving Black men aged ≥18 and reporting experiences of, or suggestions for, psychosocial support after CaP treatment were included. Low or moderate quality studies were excluded. Searches identified 4,453 articles and following deduplication, 2,325 were screened for eligibility. Two independent reviewers carried out screening, quality appraisal and data extraction. Data were analysed using thematic synthesis. RESULTS Ten qualitative studies involving 139 Black men were included. Data analysis identified four analytical constructs: experience of psychosocial support for dealing with treatment side effects (including impact on self-esteem and fear of recurrence); barriers to use of psychosocial support (such as perceptions of masculinity and stigma around sexual dysfunction); facilitators to use of psychosocial support (including the influence of others and self-motivation); and practical solutions for designing and delivering post-treatment psychosocial support (the need for trusted healthcare and cultural channels). CONCLUSIONS Few intervention studies have focused on behaviours among Black CaP survivors, with existing research predominantly involving Caucasian men. There is a need for a collaborative approach to CaP care that recognises not only medical expertise but also the autonomy of Black men as experts of their illness experience, and the influence of cultural and social networks.
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Affiliation(s)
- Olufikayo O. Bamidele
- Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, HU6 7RX UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Joel Joffe Building, Delta 900, Welton Way, Swindon, SN5 7XQ UK
| | - Motolani Ogunsanya
- Department of Pharmacy, Clinical & Administrative Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK USA
| | - Sarah Greenley
- Cancer Research Group, Hull York Medical School, University of Hull, Hull, HU6 7RX UK
| | - Aaron Worsley
- Directorate of Learning Resources, Oxford Brookes University, Oxford, OX3 OBP UK
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Prashar J, Schartau P, Murray E. Supportive care needs of men with prostate cancer: A systematic review update. Eur J Cancer Care (Engl) 2022; 31:e13541. [PMID: 35038783 PMCID: PMC9285340 DOI: 10.1111/ecc.13541] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/05/2021] [Accepted: 12/02/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Prostate cancer is highly prevalent and impacts profoundly on patients' quality of life, leading to a range of supportive care needs. METHODS An updated systematic review and thematic synthesis of qualitative data using the Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines, to explore prostate cancer patients' experience of, and need for, supportive care. Five databases (Medline, Embase, PsycInfo, Emcare and ASSIA) were searched; extracted data were synthesised using Corbin and Strauss's 'Three Lines of Work' framework. RESULTS Searches identified 2091 citations, of which 105 were included. Overarching themes emerged under the headings of illness, everyday life and biographical work. Illness work needs include consistency and continuity of information, tailored to ethnicity, age and sexual orientation. Biographical work focused on a desire to preserve identity in the context of damaging sexual side effects. Everyday life needs centred around exercise and diet support and supportive relationships with partners and peers. Work-related issues were highlighted specifically by younger patients, whereas gay and bisexual men emphasised a lack of specialised support. CONCLUSION While demonstrating some overarching needs common to most patients with prostate cancer, this review offers novel insight into the unique experiences and needs of men of different demographic backgrounds, which will enable clinicians to deliver individually tailored supportive care.
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Affiliation(s)
- Jai Prashar
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
| | - Patricia Schartau
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
| | - Elizabeth Murray
- Research Department of Primary Care and Population Health, Royal Free Hospital, University College London, London, UK
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Montiel Ishino FA, Odame EA, Villalobos K, Rowan C, Whiteside M, Mamudu H, Williams F. Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study. Am J Mens Health 2021; 15:15579883211057990. [PMID: 34836465 PMCID: PMC8646205 DOI: 10.1177/15579883211057990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The relationship of social determinants of health, Appalachian residence, and prostate cancer treatment delay among Tennessee adults is relatively unknown. We used multivariate logistic regression on 2005–2015 Tennessee Cancer Registry data of adults aged ≥18 diagnosed with prostate cancer. The outcome of treatment delay was more than 90 days without surgical or nonsurgical intervention from date of diagnosis. Social determinants in the population-based registry were race (White, Black, Other) and marital status (single, married, divorced/separated, widow/widower). Tennessee residence was classified as Appalachian versus non-Appalachian (urban/rural). Covariates include age at diagnosis (18–54, 54–69, ≥70), health insurance type (none, public, private), derived staging of cancer (localized, regional, distant), and treatment type (non-surgical/surgical). We found that Black and divorced/separated patients had 32% (95% confidence interval [CI]: 1.22–1.42) and 15% (95% CI: 1.01–1.31) increased odds to delay prostate cancer treatment. Patients were at decreased odds of treatment delay when living in an Appalachian county, both urban (odds ratio [OR] = 0.89, 95% CI: 0.82–0.95) and rural (OR = 0.83, 95% CI: 0.78–0.89), diagnosed at ≥70 (OR = 0.59, 95% CI: 0.53–0.66), and received surgical intervention (OR = 0.72, 95% CI: 0.68–0.76). Our study was among the first to comprehensively examine prostate cancer treatment delay in Tennessee, and while we do not make clinical recommendations, there is a critical need to further explore the unique factors that may propagate disparities. Prostate cancer treatment delay in Black patients may be indicative of ongoing health and access disparities in Tennessee, which may further affect quality of life and survivorship among this racial group. Divorced/separated patients may need tailored interventions to improve social support.
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Affiliation(s)
- Francisco A Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Emmanuel A Odame
- Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin Villalobos
- Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Claire Rowan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin Whiteside
- Tennessee Cancer Registry, Tennessee Department of Health, Nashville, TN, USA
| | - Hadii Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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9
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Wood AW, Martin JL, Bruns K. An Integrative Counseling Approach for African American Couples With Prostate Cancer. ADULTSPAN JOURNAL 2021. [DOI: 10.1002/adsp.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mazariego CG, Laidsaar-Powell R, Smith DP, Juraskova I. Avoiding the 'survivorship abyss': Qualitative insights from 15-year prostate cancer survivors. Psychooncology 2021; 30:1745-1755. [PMID: 34038008 DOI: 10.1002/pon.5738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/19/2021] [Accepted: 05/23/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE As many men diagnosed with prostate cancer (PC) are now living well beyond diagnosis and treatment, these survival gains necessitate improved understanding of long-term survivorship experiences. This is the first qualitative study that aimed to provide insights into PC survivors' adjustment to diagnosis and any persisting or emerging cancer/treatment-related issues over 15+ years. METHODS Semi-structured interviews were conducted with 37 men purposively sampled from the 15-year follow-up phase of a population-wide cohort study, the New South Wales Prostate Cancer Care and Outcomes Study (PCOS). Interview data were transcribed and thematically analysed applying a framework methodology. RESULTS The majority of participating men (88.6%) had been diagnosed with localised disease and were treated with radical prostatectomy as primary treatment (54.1%). Four main interconnecting themes relating to men's long-term survivorship experience with PC were identified: (1) Survivorship reflections, (2) interactions with the healthcare system, (3) personal and social relationships and (4) dominant coping strategies. Many men reported gaps along the continuum of care and a feeling of abandonment across their long-term survivorship, encompassed by a perceived lack of psychosocial and informational support for persisting treatment side-effects, especially sexual dysfunction. Receiving adequate survivorship care and trusting patient-clinician relationships appeared to be associated with greater resilience and positivity in the men's acceptance of cancer-related long-term challenges and personal limitations. CONCLUSIONS Long-term PC survivors continue to experience lasting treatment impacts, with many men reporting unmet needs and a lack of continuity of multidisciplinary care. Implementation of coordinated and tailored survivorship care and shared care pathways with multidisciplinary practitioners will facilitate men's improved engagement and timely access to supportive care interventions, helping to avoid the 'survivorship abyss'.
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Affiliation(s)
- Carolyn G Mazariego
- The Daffodil Centre a Joint Venture with Cancer Council New South Wales, The University of Sydney, Sydney, Australia
| | - Rebekah Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - David P Smith
- The Daffodil Centre a Joint Venture with Cancer Council New South Wales, The University of Sydney, Sydney, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ilona Juraskova
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Adams RD, Johnson WE. Faith as a Mechanism for Health Promotion among Rural African American Prostate Cancer Survivors: A Qualitative Examination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3134. [PMID: 33803629 PMCID: PMC8003072 DOI: 10.3390/ijerph18063134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 01/04/2023]
Abstract
Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.
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Affiliation(s)
- Raymond D. Adams
- Department of Social Work, Psychology & Counseling, College of Education, Humanities, and Behavioral Sciences, Alabama A&M University, Normal, AL 35810 1, USA
| | - Waldo E. Johnson
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, IL 60637 2, USA
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Ruiz-Rodríguez I, Hombrados-Mendieta I, Melguizo-Garín A, Martos-Méndez MJ. The Association of Sources of Support, Types of Support and Satisfaction with Support Received on Perceived Stress and Quality of Life of Cancer Patients. Integr Cancer Ther 2021; 20:1534735421994905. [PMID: 33736509 PMCID: PMC7983427 DOI: 10.1177/1534735421994905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/12/2020] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The aim of the present study is to carry out a multidimensional analysis of the relationship of social support with quality of life and the stress perceived by cancer patients. METHODS The participants were 200 patients with cancer. Data was gathered on sociodemographic characteristics, health, quality of life, social support and perceived stress. RESULTS Frequency of and satisfaction with different sources and types of support are related positively with improvement of quality of life and negatively with perceived stress. The emotional support from the partner and the emotional and informational support from the family are significant predictors of quality of life. Emotional support from the family reduces patients' perceived stress. Satisfaction with emotional support from the partner and with the informational support from friends and family increases quality of life. Satisfaction with emotional support from the family and with informational support from friends decreases patients' perceived stress. Instrumental support and support provided by health professionals are not good predictors of quality of life and perceived stress. Satisfaction with the support received is more significantly related with quality of life and stress than the frequency with which the sources provide support. CONCLUSIONS These results have important practical implications to improve cancer patients' quality of life and reduce their perceived stress through social support. Designing intervention strategies to improve satisfaction with the support provided to patients by their closest networks results in a global benefit for the patient's quality of life.
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Palmer NR, Shim JK, Kaplan CP, Schillinger D, Blaschko SD, Breyer BN, Pasick RJ. Ethnographic investigation of patient-provider communication among African American men newly diagnosed with prostate cancer: a study protocol. BMJ Open 2020; 10:e035032. [PMID: 32759241 PMCID: PMC7409964 DOI: 10.1136/bmjopen-2019-035032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In the USA, African American men bear a disproportionate burden of prostate cancer (PCa) compared with all other groups, having a higher incidence and mortality, poorer quality of life and higher dissatisfaction with care. They are also less likely to receive guideline-concordant treatment (eg, undertreatment of aggressive disease). Inadequate patient-provider communication contributes to suboptimal care, which can be exacerbated by patients' limited health literacy, providers' lack of communication skills and time constraints in low-resource, safety net settings. This study is designed to examine the communication experiences of African American patients with PCa as they undertake treatment decision-making. METHODS AND ANALYSIS Using an ethnographic approach, we will follow 25 African American men newly diagnosed with PCa at two public hospitals, from diagnosis through treatment decision. Data sources include: (1) audio-recorded clinic observations during urology, radiation oncology, medical oncology and primary care visits, (2) field notes from clinic observations, (3) patient surveys after clinic visits, (4) two in-depth patient interviews, (5) a provider survey, and (6) in-depth interviews with providers. We will explore patients' understanding of their diagnoses and treatment options, sources of support in decision-making, patient-provider communication and treatment decision-making processes. Audio-recorded observations and interviews will be transcribed verbatim. An iterative process of coding and team discussions will be used to thematically analyse patients' experiences and providers' perspectives, and to refine codes and identify key themes. Descriptive statistics will summarise survey data. ETHICS AND DISSEMINATION To our knowledge, this is the first study to examine in-depth patient-provider communication among African American patients with PCa. For a population as marginalised as African American men, an ethnographic approach allows for explication of complex sociocultural and contextual influences on healthcare processes and outcomes. Study findings will inform the development of interventions and initiatives that promote patient-centred communication, shared decision-making and guideline-concordant care. This study was approved by the University of California San Francisco and the Alameda Health System Institutional Review Boards.
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Affiliation(s)
- Nynikka R Palmer
- Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Center for Vulnerable Populations, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Janet K Shim
- Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Celia P Kaplan
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Dean Schillinger
- Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Center for Vulnerable Populations, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - Sarah D Blaschko
- Division of Urology, Highland Hospital, Oakland, California, USA
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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14
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Bamidele O, McGarvey H, Lagan BM, Parahoo K, Chinegwundoh Mbe F, McCaughan E. "Man in the driving seat": A grounded theory study of the psychosocial experiences of Black African and Black Caribbean men treated for prostate cancer and their partners. Psychooncology 2019; 28:1712-1720. [PMID: 31216078 DOI: 10.1002/pon.5150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Evidence suggests that treatment side-effects of prostate cancer (CaP) substantially affect the psychosocial well-being of affected men and their partners. However, this phenomenon is poorly understood among high risk (1 in 4) Black African (BA)/Black Caribbean (BC) men and their partners, as they are currently under-represented in global research on CaP survivorship. This study explored the psychosocial experiences of BA/BC men with CaP and their partners in the United Kingdom as they lived through the side effects of CaP treatment within their own sociocultural and marital contexts. METHODS Using constructivist grounded theory methodology, interviews and focus groups were conducted with eligible men (n = 25), partners (n = 11), and health care professionals (HCPs) (n = 11) recruited in England. Data were iteratively analysed using constant comparison following the key stages of initial, focused, and theoretical coding until saturation was achieved. RESULTS Data analysis culminated in the development of a substantive theory "man in the driving seat," which describes the experiences of BA/BC men with CaP and their partners within their context. Culturally informed gender roles and identities influenced how men and partners responded and coped with the side effects of CaP treatment. There was a hierarchy of power within the BA/BC relationship, in which men were dominantly positioned as leaders, whilst partners mostly operated from a supportive but "accepting" position. CONCLUSION Inclusive and culturally sensitive individual and couple-focused psychosocial support, which is devoid of stereotyping and recognises the experiences of both BA/BC men and their partners is recommended.
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Affiliation(s)
- Olufikayo Bamidele
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland
| | - Helen McGarvey
- School of Nursing, Ulster University, Londonderry, Northern Ireland
| | - Briege M Lagan
- Institute of Nursing and Health Research and School of Nursing, Ulster University, Jordanstown, Northern Ireland
| | - Kader Parahoo
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland
| | | | - Eilís McCaughan
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland
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15
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Khan S, Nepple KG, Kibel AS, Sandhu G, Kallogjeri D, Strope S, Grubb R, Wolin KY, Sutcliffe S. The association of marital status and mortality among men with early-stage prostate cancer treated with radical prostatectomy: insight into post-prostatectomy survival strategies. Cancer Causes Control 2019; 30:871-876. [PMID: 31214808 DOI: 10.1007/s10552-019-01194-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/12/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to determine the association of marital status, a marker of social support, with all-cause and prostate cancer-specific mortality in a cohort of men with early-stage prostate cancer treated with radical prostatectomy. METHODS We conducted a retrospective cohort study of 3,579 men treated for localized (stage 1-2) prostate cancer with radical prostatectomy at a single institution between 1994 and 2004. Marital status (not married vs. married) and marital history (never married, divorced, widowed vs. married) at the time of prostatectomy were examined in relation to (1) all-cause mortality and (2) prostate cancer-specific mortality using Cox proportional hazards regression. RESULTS Not being married (vs. married) at the time of radical prostatectomy was associated with an increased risk of all-cause mortality [Hazard Ratio (HR) 1.42; 95% Confidence Interval (CI) 1.10, 1.85]. Similarly, in analyses of marital history, never-married men were at highest risk of all-cause mortality (HR 1.77, 95% CI 1.19, 2.63). Unmarried status (vs. married) was also associated with an increased risk of prostate cancer-specific mortality (HR 1.97; 95% CI 1.01, 3.83). CONCLUSIONS Unmarried men with prostate cancer were at greater risk for death after radical prostatectomy. Among married men with prostate cancer, marriage likely serves as a multi-faceted proxy for many protective factors including social support. Future studies should explore the mechanisms underlying these findings to inform the development of novel prostate cancer survival interventions for unmarried men and those with low social support.
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Affiliation(s)
- Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.
| | - Kenneth G Nepple
- Department of Urology, Carver College of Medicine, University of Iowa Health Care, 3228 RCP, Iowa City, IA, 52242, USA
| | - Adam S Kibel
- Division of Urology, Department of Surgery, Brigham and Women's Hospital, Harvard School of Medicine, 45 Francis St., ASB11-3, Boston, MA, 02115, USA
| | - Gurdarshan Sandhu
- Mercy Clinic Urology, David C. Pratt Cancer Center, 607 S. New Ballas Rd., Suite 3100, St. Louis, MO, 63141, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8042, St. Louis, MO, 63110, USA
| | - Seth Strope
- Urology of St. Louis, 12855 North Forty Dr., Suite 375, St. Louis, MO, 63141, USA
| | - Robert Grubb
- Department of Urology, Medical University of South Carolina, 135 Rutledge Ave., Charleston, SC, 29425, USA
| | - Kathleen Y Wolin
- Interactive Health Inc., 300 N. Elizabeth St., Chicago, IL, 60607, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
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16
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Heath EI, Nanus DM, Slovin S, Strand C, Higano C, Simons VH, Johnson C, Kyriakopoulos CE, Reichert ZR, Lory S, George DJ, Mucci LA, Marcus JD, Trendel JA, Bock CH. Prostate Cancer National Summit's Call to Action. Clin Genitourin Cancer 2019; 17:161-168. [PMID: 31085057 DOI: 10.1016/j.clgc.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/01/2019] [Accepted: 04/09/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Elisabeth I Heath
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI.
| | - David M Nanus
- Division of Hematology and Oncology, Department of Medicine, Weill Cornell Medicine and Meyer Cancer Center, New York, NY
| | - Susan Slovin
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Celestia Higano
- Fred Hutchinson Cancer Research Center and Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | | | - Crawford Johnson
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, and Sidney Kimmel Comprehensive Cancer Center, Department of Urology, Johns Hopkins University, Baltimore, MD
| | - Christos E Kyriakopoulos
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Zachery R Reichert
- Division of Hematology/Oncology, Department of Internal Medicine and University of Michigan Comprehensive Cancer Center, Ann Arbor, MI
| | | | - Daniel J George
- Division of Medical Oncology, Department of Medicine and Duke Cancer Institute, Duke University Medical Center, Durham, NC
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | - Jill A Trendel
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
| | - Cathryn H Bock
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
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17
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Beebe-Dimmer JL, Albrecht TL, Baird TE, Ruterbusch JJ, Hastert T, Harper FWK, Simon MS, Abrams J, Schwartz KL, Schwartz AG. The Detroit Research on Cancer Survivors (ROCS) Pilot Study: A Focus on Outcomes after Cancer in a Racially Diverse Patient Population. Cancer Epidemiol Biomarkers Prev 2019; 28:666-674. [PMID: 30482875 PMCID: PMC6449184 DOI: 10.1158/1055-9965.epi-18-0123] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/04/2018] [Accepted: 11/20/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African Americans are often diagnosed with advanced stage cancer and experience higher mortality compared with whites in the United States. Contributing factors, like differences in access to medical care and the prevalence of comorbidities, do not entirely explain racial differences in outcomes. METHODS The Detroit Research on Cancer Survivors (ROCS) pilot study was conducted to investigate factors related to short- and long-term outcomes among patients with cancer. Participants completed web-based surveys, and mailed saliva specimens were collected for future genetic studies. RESULTS We recruited 1,000 participants with an overall response rate of 68%. Thirty-one percent completed the survey without any interviewer support and the remaining participated in an interviewer-administered survey. Seventy-four percent provided a saliva specimen and 64% consented for tumor tissue retrieval. African American survivors required more interviewer support (P < 0.001); however, their response rate (69.6%) was higher than non-Hispanic whites (65.4%). African Americans reported poorer overall cancer-related quality of life compared with non-Hispanic whites, measured by FACT-G score (P < 0.001), however, this relationship was reversed after controlling for socioeconomic factors, marital status, and the presence of comorbidities. CONCLUSIONS In this pilot study, we demonstrated that a web-based survey supplemented with telephone interviews and mailed saliva kits are cost-effective methods to collect patient-reported data and DNA for large studies of cancer survivors with a high proportion of minority patients. The preliminary data collected reinforces differences by race in factors affecting cancer outcomes. Our efforts continue as we expand this unique cohort to include more than 5,000 African American cancer survivors. IMPACT Formal investigation of factors influencing adverse outcomes among African American cancer survivors will be critical in closing the racial gap in morbidity and mortality.
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Affiliation(s)
- Jennifer L Beebe-Dimmer
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan.
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Terrance L Albrecht
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Tara E Baird
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Julie J Ruterbusch
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Theresa Hastert
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Felicity W K Harper
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Michael S Simon
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Judith Abrams
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Kendra L Schwartz
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Family Medicine, School of Medicine, Wayne State University, Detroit, Michigan
| | - Ann G Schwartz
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
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18
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Smith L, Lee JA, Mun J, Pakpahan R, Imm KR, Izadi S, Kibel AS, Colditz GA, Grubb RL, Wolin KY, Sutcliffe S, Yang L. Levels and patterns of self-reported and objectively-measured free-living physical activity among prostate cancer survivors: A prospective cohort study. Cancer 2018; 125:798-806. [PMID: 30516839 PMCID: PMC6378115 DOI: 10.1002/cncr.31857] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/29/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
Background No prior study has measured or compared self‐reported and objectively measured physical activity trajectories in prostate cancer survivors before and after treatment. Methods Clinically localized prostate cancer patients treated with radical prostatectomy were recruited between 2011 and 2014. Of the 350 participants enrolled at the main site, 310 provided self‐reported physical activity at baseline before radical prostatectomy, and 5 weeks, 6 months, and 12 months after radical prostatectomy. A subset of participants (n = 81) provided objectively measured physical activity at all study time points by wearing an accelerometer for 7 days each. Changes in activity over time were compared using Friedman’s test. Agreement between self‐reported and objective measures was evaluated using Spearman’s rank correlation coefficient. Results Self‐reported moderate‐to‐vigorous physical activity was high at baseline (median, 32.1 min/day), followed by a decline at 5 weeks (median, 15.0 min/day) and a recovery at 6 and 12 months (median, 32.1‐47.1 min/day). In contrast, objectively measured moderate‐to‐vigorous physical activity was low at all 4 time points (median, 0.0‐5.2 min/day), with no overall change across study assessments (global P = .29). Self‐reported moderate‐to‐vigorous physical activity tended to be more closely related to objectively measured light‐intensity physical activity (ρ = 0.29‐0.42) than to objectively measured moderate‐to‐vigorous physical activity (ρ = 0.07‐0.27, P = .009‐.32). Conclusions In our population of prostate cancer survivors with critically low moderate‐to‐vigorous physical activity levels, self‐reported measures greatly overestimated moderate‐to‐vigorous physical activity and may have been more reflective of light‐intensity physical activity. Because cancer survivor guidelines are derived from self‐reported data, our findings may imply that intensities of physical activity below moderate, such as light intensity, still have health benefits. In a population of 81 prostate cancer survivors with critically low moderate‐to‐vigorous physical activity levels, self‐reported measure greatly overestimates moderate‐to‐vigorous physical activity and may be more reflective of light‐intensity physical activity. Because prostate cancer guidelines are derived from self‐reported moderate‐to‐vigorous physical activity, the findings imply that lower intensities of physical activity, such as light‐intensity physical activity, may still have health benefits.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jung Ae Lee
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Agricultural Statistics Laboratory, Division of Agriculture, University of Arkansas, Fayetteville, Arkansas
| | - Junbae Mun
- Department of Physical Education, Korea Military Academy, Seoul, Republic of Korea
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Kellie R Imm
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sonya Izadi
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Adam S Kibel
- Division of Urology, Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Robert L Grubb
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | | | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Lin Yang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Epidemiology, Medical University of Vienna, Vienna, Austria
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Choi SK, Seel JS, Yelton B, Steck SE, McCormick DP, Payne J, Minter A, Deutchki EK, Hébert JR, Friedman DB. Prostate Cancer Information Available in Health-Care Provider Offices: An Analysis of Content, Readability, and Cultural Sensitivity. Am J Mens Health 2018; 12:1160-1167. [PMID: 29649921 PMCID: PMC6131445 DOI: 10.1177/1557988318768599] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer (PrCA) is the most common cancer affecting men in the United States, and
African American men have the highest incidence among men in the United States. Little is
known about the PrCA-related educational materials being provided to patients in
health-care settings. Content, readability, and cultural sensitivity of materials
available in providers’ practices in South Carolina were examined. A total of 44
educational materials about PrCA and associated sexual dysfunction was collected from 16
general and specialty practices. The content of the materials was coded, and cultural
sensitivity was assessed using the Cultural Sensitivity Assessment Tool. Flesch Reading
Ease, Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook were used to
assess readability. Communication with health-care providers (52.3%), side effects of PrCA
treatment (40.9%), sexual dysfunction and its treatment (38.6%), and treatment options
(34.1%) were frequently presented. All materials had acceptable cultural sensitivity
scores; however, 2.3% and 15.9% of materials demonstrated unacceptable cultural
sensitivity regarding format and visual messages, respectively. Readability of the
materials varied. More than half of the materials were written above a high-school reading
level. PrCA-related materials available in health-care practices may not meet patients’
needs regarding content, cultural sensitivity, and readability. A wide range of
educational materials that address various aspects of PrCA, including treatment options
and side effects, should be presented in plain language and be culturally sensitive.
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Affiliation(s)
- Seul Ki Choi
- 1 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jessica S Seel
- 2 Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Brooks Yelton
- 2 Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Susan E Steck
- 3 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Johnny Payne
- 5 UsTOO Greenville and Upstate Prostate Cancer Alliance, Easley, USA
| | - Anthony Minter
- 6 USToo Columbia and ZERO Prostate Cancer, Columbia, SC, USA
| | - Elizabeth K Deutchki
- 7 Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- 2 Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,3 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- 1 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,2 Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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