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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Prostate cancer (PC) has recently surpassed lung cancer as the most common cancer of U.S. men. Men with PC who are treated with surgery or radiation therapy often experience urinary and bowel incontinence and erectile dysfunction, and are likely to live with these problems for years. As a result, PC can negatively impact not only the patient, but also his caregiving spouse/partner. As cancer treatment becomes increasingly provided on an outpatient basis, much of the cancer burden of care has shifted from health care professionals to informal caregivers (e.g., partners/spouses). Family caregiving (CG) carries psychosocial costs, with caregivers more likely than non-caregivers to ignore their own mental and physical health needs. Research with family caregivers of cancer patients suggest that chronic caregiving responsibilities and the uncertainties of cancer disease course can lead to increased caregiver distress. PC can have a negative impact on the patient and caregiving partner dyad in a number of ways including changes in physical/sexual functioning, social functioning and psychological well-being. Relatively few psychosocial interventions have been developed and tested to help PC patients; and those that have been evaluated tend to minimize spouse involvement. Although several interventions have been developed for family caregivers of cancer patients in general, cancer caregiver interventions that target treatment related symptoms like nausea or pain appear less relevant in the localized PC experience which involves sexual dysfunction and urinary and bowel incontinence. Only one randomized clinical trial has focused on PC spousal caregivers with very modest results. Moreover, growing research suggests that PC spouses report a lack of preparedness in taking on the caregiving role and have a variety of unmet needs that warrant additional investigation to assist in effective intervention design and delivery. The principal investigator of the proposed project has documented expertise in the development of interventions for family caregivers; however, he has a desire to refocus his work to behavioral research in cancer with an emphasis on the design of effective interventions for PC spousal caregivers. This application uses a mixed method approach and an innovative model of caregiving emerging in the literature to explore the relationship between patient suffering and caregiver compassion and to achieve the project's aims. The project collects and analyzes qualitative and quantitative data from PC patients and their caregivers representing 3 different cultural groups. Results will be used to modify existing or develop new interventions for PC patients and their caregivers. Interventions focusing on patient suffering and caregiver compassion would provide an important new perspective on interventions for PC survivors and CG partners; and, these types of programs may prove particularly useful to clinicians and policy makers, since they are likely to improve both patient and caregiver functioning. Prostate cancer (PC) is the most common cancer of U.S. men, and PC patients treated with surgery or radiation therapy often experience urinary and bowel incontinence and sexual dysfunction for years. Thus, PC can negatively impact both the patient and his caregiving spouse/partner who, as a result, often experiences substantial physical and emotional strain. This project conducts formative research to help develop interventions to improve the physical and psychosocial functioning of the PC couple.