BACKGROUND/RATIONALE:
Annually 40,000 to 50,000 prostate cancer patients, who have received definitive treatment, experience PSA failure. PSA failure is operationally defined as a rise in PSA value 0.2 ng/ml on repeat testing for patients who have received a radical prostatectomy and either 2 rises above nadir or a PSA value >50% above nadir for patients with prior radiation therapy. While there is no strong medical evidence that supports treatment for men with PSA failure, many do receive treatment, which has implications for quality of life and decision satisfaction.
OBJECTIVE(S):
Our purpose is to develop a three site, longitudinal, collaborative project to recruit a cohort of 300 lower socioeconomic status (SES) prostate cancer survivors experiencing biochemical recurrence or PSA failure after initial, definitive treatment of apparently localized disease.
Specific Aims: Our primary aim is to assess variations in patters of care (treatment vs. no-treatment) for patients with PSA failure and to evaluate differences in health related quality of life, treatment preferences and decision satisfaction.
METHODS:
Three hundred patients will be recruited from three VA hospitals. Patients will have previously received curative local therapy and are considered PSA failures. Study personnel will interview patients at time of PSA failure, 3 months, 12 months, 18 months, 24 months, 30 months, and 36 months after enrollment. At each time interval, patients will complete HRQL, literacy and decision satisfaction assessments. At the initial point of contact, a patient's caregiver will complete quality of life related assessments. All interviews will be conducted face to face.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Prostate cancer is the second leading cancer among all American males. With the aging of the population, the increasing use of PSA screening and the continued public profile of the disease, it is the major oncologic problem facing older Americans today. As more patients choose treatment at the time of diagnosis, a greater population of patients may later face a second time when they will be forced to make a treatment decision. This project will provide the first set of data on quality of life, patient preference, decision satisfaction and patterns of care for lower socioeconomic individuals.
PUBLICATIONS:
Journal Articles
- Schickedanz AD, Schillinger D, Landefeld CS, Knight SJ, Sudore RL. Barriers to advance care planning in diverse older adults. Journal of The American Geriatrics Society. 2007; 55(S2): 45.
