Poorer quality of life for gay men and minorities after prostate cancer treatment: What are we missing?
To improve the quality of life in gay men and minorities treated for prostate cancer, a greater awareness of ethnic and sexual preference-related factors is needed to help men choose a more-suitable treatment plan, researchers from Thomas Jefferson University Hospital conclude in a literature review published May 1 in Nature Reviews Urology.
Some of the factors to consider, for example, include increased risk of urinary and bowel function decline in African Americans regardless of treatment received and differing sexual expectations and social support in gay men.
"Different communities of men view the effects of prostate cancer treatments very differently," said co-author Edouard J. Trabulsi, M.D., of the Department of Urology and Kimmel Cancer Center at Thomas Jefferson University Hospital, noting the poorer quality of life among certain subpopulations.
"It's in the patient's best interest for caregivers to acknowledge perceptions and expectations during the treatment decision process," he said. "They should take specific demographics, socioeconomic status, and sexual preference into consideration, and tailor an approach based on a patient's specific concerns about the implications of various treatments."
Today, many of these confounding factors are poorly documented and poorly addressed by medical practitioners when discussing treatment, be it radical prostatectomy, radiation or androgen deprivation therapy. There is also scant research about prostate-cancer-related quality of life effects in men who have sex with men (MSM).
In this literature review, the authors use several studies to illustrate differences in treatment outcomes, sexual function and coping mechanisms among subpopulations, including African Americans, Latin Americans, Asians and MSM.
According to the analysis, African Americans, who have higher prostate cancer incidence and mortality rates than whites, are less likely to initiate and complete treatment and less likely to trust a physician. They are also at an increased risk of urinary, bowel and general physical function decline, regardless of treatment.
Treatment preferences and sexual outcomes also differ. According to the review, in a study of 665 military men who had the same access to care, white men were three times more likely to choose a radical prostatectomy as their treatment options for low and intermediate risk prostate cancer, whereas African Americans tended to prefer non-surgical treatments, such as external beam radiation therapy.
A multicenter longitudinal cohort study set up to monitor urinary and sexual function in over 1,200 men who underwent radical prostatectomy for clinically localized prostate cancer showed that African Americans were more likely to retain sexual function.
As with African Americans, Latin American men who underwent radiation therapy or a radical prostatectomy demonstrated greater levels of severe sleep dysfunction than whites. They were also are less likely to enter hospice.
MSM with prostate cancer have additional social and sexual challenges often overlooked. MSM are typically diagnosed later in life and may be reluctant to divulge their sexual preference to their caregiver. This may preclude them from discussing their quality of life expectations and sexual practices.
One reason for poorer quality of life may also be attributed to a lack of social support group, the researchers discovered in their analysis. As MSM men are less likely to have long-term partners, they might not have the same level of support at home and might look for support in other places.
However, the number of support groups specifically tailored for MSM with prostate cancer is limited.
"In the United States, MSM-specific support groups are available in just six cities. MSM living outside these cities might rely more on Internet-based support groups and are at increased risk of becoming socially isolated," the authors write.
MSM are also less likely to invite their partners into the examiner room when discussing treatment options and related adverse effects. Study findings also suggest that treatment with androgen deprivation therapy for prostate cancer could have a greater negative impact on quality of life for gay men compared to heterosexual men.
"There are potential barriers for accurately assessing and measuring quality of life in MSM. Here, we focus attention on these poorly studied aspects to help overcome such concerns," said Dr. Trabulsi, who is also the Director of the Multidisciplinary Genitourinary Cancer Center at Jefferson's Kimmel Cancer Center. "It's everything from discussion about sexual preference to toxicity-related effects to their ability to maintain a relationship with a partner."
Provided by
Thomas Jefferson University
-
Men have overly optimistic expectations about recovery from prostate cancer surgery
Aug 08, 2011 |
not rated yet |
0
-
Sexual function does not continuously decline after radiation therapy treatments for prostate cancer
Jan 05, 2010 |
not rated yet |
0
-
Higher HIV risk in black gay men linked to partner choice, risk perception
May 02, 2011 |
not rated yet |
0
-
Family history of prostate cancer does not affect some treatment outcomes
Jan 02, 2009 |
not rated yet |
0
-
Surgery better than radiation, hormone treatments for some prostate cancer, study shows
Aug 06, 2010 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
How can there be a term called "intestinal metaplasia" of stomach
21 hours ago
-
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013
-
If you became brain-dead, would you want them to pull the plug?
May 17, 2013
-
MRI bill question
May 15, 2013
-
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013
-
Alcohol and acetaminophen
May 13, 2013
- More from Physics Forums - Medical Sciences
More news stories
Small cancer risk following CT scans in childhood and adolescence confirmed
The gap between life expectancy in patients with a mental illness and the general population has widened since 1985 and efforts to reduce this gap should focus on improving physical health, suggest researchers in a paper ...
Cancer
10 hours ago |
not rated yet |
0
Changing cancer's environment to halt its spread
By studying the roles two proteins, thrombospondin-1 and prosaposin, play in discouraging cancer metastasis, a trans-Atlantic research team has identified a five-amino acid fragment of prosaposin that significantly reduces ...
Cancer
11 hours ago |
not rated yet |
0
Novel RNA-based classification system for colorectal cancer
A novel transcriptome-based classification of colon cancer that improves the current disease stratification based on clinicopathological variables and common DNA markers is presented in a study published in PLOS Medicine this w ...
Cancer
11 hours ago |
not rated yet |
0
Low radiation scans help identify cancer in earliest stages
A study of veterans at high risk for developing lung cancer shows that low-dose computed tomography (LDCT) can be highly effective in helping clinicians spot tiny lung nodules which, in a small number of patients, may indicate ...
Cancer
13 hours ago |
not rated yet |
0
Poliovirus vaccine trial shows early promise for recurrent glioblastoma
An attack on glioblastoma brain tumor cells that uses a modified poliovirus is showing encouraging results in an early study to establish the proper dose level, researchers at Duke Cancer Institute report.
Cancer
15 hours ago |
not rated yet |
0
Phthalates: Study links chemicals widely found in plastics, processed food to elevated blood pressure in children, teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the ...
If you can remember it, you can remember it wrong
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
B vitamins could delay dementia
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
Insight into the dazzling impact of insulin in cells
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
New sleeping pill poised to hit US markets
An experimental sleeping pill from US drug company Merck is effective at helping people fall and stay asleep, according to reviewers at the US Food and Drug Administration, which could soon approve the new drug.
Reducing caloric intake delays nerve cell loss
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...