African-American survivors of prostate cancer have unmet psychosocial needs

Researchers at Moffitt Cancer Center have found that in African-American families where men are diagnosed with prostate cancer, they have unmet psychosocial needs that affect their survivorship, as well as family and social relationships.

The study, recently published in the Journal of Cancer Education, focused on better understanding the African-American male and family prostate cancer survivorship experience.

"African-Americans continue to experience higher morbidity and mortality rates from prostate cancer and lower survival rates when compared to men of other ethnic and racial groups," said study lead author Brian M. Rivers, Ph.D., M.P.H., assistant member of Health Outcomes & Behavior.

According to the researchers, the difference in prostate cancer survivorship and quality of life outcomes for African-American men and their families as compared to other groups is likely due to a number of factors and their combination:

•Stage of cancer at diagnosis
•Tumor biology
•Insurance coverage
•Lack of prostate cancer knowledge
•Mistrust, fear and lack of culturally appropriate interventions
•Inadequate communication between patient and health care provider

"Prostate cancer treatment not only impacts the survivor, but also the primary caregiver and family members," Rivers said. "Our aim was to examine the role of sociocultural factors on the psychosocial impact among African-American prostate cancer survivors. Little has been documented on how African-American prostate cancer survivors respond and cope with physical and psychosocial outcomes."

To carry out the study, the researchers interviewed 12 African-American couples recruited from a National Cancer Institute Comprehensive Cancer Center registry and a state-based nonprofit organization. The couples were interviewed to obtain their perspectives on a number of quality-of-life issues, including physical and spiritual well-being, communications between caregiver and patient, and communication between spouses.

The researchers found that African-American survivors of prostate cancer had unmet needs in terms of dealing with fears of recurrence while their spouses reported fears of not having enough information. Men reported having limited conversations with their wives about their cancer and treatment. Two-thirds of the spouses "did not force" conversations with their husbands about cancer because they were concerned about stress and anxiety within the marriage. Survivors reported not being comfortable about disclosing to their wives their feelings about erectile dysfunction and other physical changes.

The findings also allowed researchers to better understand the importance of a prostate cancer survivor's social network and how social networks contributed to their social well-being.

"Several findings from this study point to the need for culturally appropriate interventions that include the role and impact of spirituality, better information for couples regarding symptoms and symptom management, and more effective communication paths," concluded the researchers. "Future interventions should target the late and long-term effect of prostate cancer treatment and should be expanded. Interventions should include marital/family care with a focus on information and the skills to help manage family and marriage concerns in communication, teamwork and intimate relationships."