Prostate Cancer Survivors with Rising PSA and Their Spouses: Treatment Decision Making and Quality of Life

摘要

Advances in the treatment of prostate cancer have produced excellent 5-year survival chances. Despite this success, a growing number of patients experience a rise in prostate-specific antigen (PSA) levels after treatment. Even if widespread disease is not found, a rising PSA is a sign that prostate cancer might have recurred. From a psychological point of view, patients and their spouses/partners are forced to deal with a disease they believed they have overcome. For a second time they face a health decision with few treatment guidelines, the potential for substantial side-effects, and uncertain outcomes, including the possibility of death. This study involves patients and their spouses/partners who are attending two medical institutions: the Deane Prostate Health and Research Center in the Department of Urology at Mount Sinai Hospital, New York City, and the Department of Medical Oncology at Fox Chase Cancer Center, Philadelphia, PA. Patients will have been diagnosed with rising PSA but have no clinical evidence of cancer. Eligible patients and their spouse/partners who have agreed to participate (n=191) will take part in a 6- month-long assessment study. During this time, they will be interviewed via questionnaires three times: at the beginning (baseline), at 6-months, and when they have made a treatment decision. Our research focus and the measures used for data collection are guided by our cognitive-social health information processing (C-SHIP) theoretical framework. This framework incorporates individuals' experiences, expectations, beliefs, values, and emotional responses to a health threat, and sees these components as influential factors in treatment decision making. Both the patient and the spouse/partner will be assessed. Due to the limited patient enrollment, no significant findings can be reported at this time. We plan to keep the study open as an unfunded project at both institutions to accrue more participants.