Publication Date

2012-08-03

Availability

Open access

Embargo Period

2012-08-03

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2012-04-05

First Committee Member

Frank J. Penedo

Second Committee Member

Youngmee Kim

Third Committee Member

Michael H. Antoni

Fourth Committee Member

Monica Webb Hooper

Fifth Committee Member

Jason R. Dahn

Abstract

Research conducted with prostate cancer (PC) survivors has previously noted ethnic disparities in knowledge about PC, fatalism about a PC diagnosis, and linked these disparities to poor adherence to PC screening recommendations. This poor adherence may be an important factor explaining why Black and Hispanic men tend to present for treatment at a more advance stage that is more likely to be fatal. While 5 year survival rates for PC approach 100%, men often report problems with sexual function that they are quite bothered by and which negatively affect their overall quality of life. However the evidence for ethnic disparities in post treatment sexual function has yielded mixed results while examinations of disparities in sexual bother are few in number. This study examined the influence of cancer fatalism and prostate cancer knowledge before treatment on sexual function and sexual bother after treatment for localized PC. Exploratory analyses sought to determine if race/ethnicity moderates any relationship between cancer fatalism or PC knowledge and sexual function and bother. The participants included approximately 60 ethnically diverse men diagnosed with localized prostate cancer within the past month who were recruited prior to receiving any treatment. Participants were drawn from the Prostate Cancer and Treatment Health Study (PATHS), a prospective observational study funded by the National Cancer Institute to determine the influence of ethnic group membership on quality of life and disease related outcomes among men diagnosed with PC. Results of this study did not demonstrate any ethnic differences in cancer fatalism or PC knowledge prior to treatment for PC. Likewise, no ethnic differences in sexual function or sexual bother were evidenced one month after treatment. After controlling for age, co-morbid conditions and years of education, treatment type was the only significant predictor of sexual function one month after treatment. Descriptive analyses indicated that men who received internal or external radiation experienced the least decline in sexual function. Post hoc analyses conducted with men treated using radical prostatectomy, demonstrated that Black men reported the lowest levels of PC knowledge along with the highest co-morbid condition severity scores. These findings underscore the importance of including Black men in programs designed to improve the PC knowledge of men at increased risk for the disease. Limitations and ideas for future work are elaborated on in the discussion section.

Keywords

prostate cancer; sexual function; quality of life; prostate cancer knowledge; cancer fatalism; ethnicity

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