Assessing the impact of comorbid illnesses on death within 10 years in prostate cancer treatment candidates

151 Background: Decision aids (DAs) for prostate cancer treatment can improve knowledge and reduce decisional conflict, but the relative effect of pre-visit and within-visit DAs is not known, and effect sizes for minority populations has not been estimated. Methods: We conducted a 3-arm, patient-level-RCT in specialty urology and radiation oncology practices in Ohio, South Dakota, and Alaska, test the effect of pre-consultation and with-in consultation decision aids on patient knowledge immediately after specialty consultation compared to usual care. We used linear regression to estimate effects of each intervention arm, including the respective standard error, two-sided 95% confidence interval, and two-sided P value for testing the study’s hypotheses. Results: 103 patients were recruited and randomized to receive either the pre-visit decision aid, within-visit decision aid, or neither decision aids (usual care). In 2017 and 20018, we accrued similar numbers of men to pre-consultation aid (n = 37), during-consultation aid (n = 33) and usual care arms, respectively (n = 33). The median (range) age in years was 64 [49, 81]; 67.6% were White, 15.7% were Black or African American, 16.7% were American Indian or Alaska Native, and 1% were not reported. 47.6%, 45.6%, and 6.8% had a baseline clinical stage of T1, T2, and T3, respectively. The median [range] prostate specific antigen (PSA) was 8.0 [2.4, 53.7]. There were no clinically notable imbalances. We obtained usable data on 102 of the 103 patient-participants. The pre-visit decision aid arm showed a mean knowledge effect of 0.694 (0.636, 0.753). The within-visit decision arm showed a very similar mean knowledge effect of 0.686 (0.625, 0.748). The usual care arm showed a mean knowledge effect of 0.644 (0.582,0.705). The linear regression model showed, that, compared with usual care, neither intervention effect achieved statistical significance in the primary analysis (p = 0.24, 0.330, for pre-visit and within-visit, respectively). Conclusions: Modest knowledge gains of pre-visit and during-visit decision aids for prostate cancer treatment were not statistically significant. Clinical trial information: NCT03182998 .

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Prostate Cancer Treatment and Work: A Scoping Review

American Journal of Men s Health ◽

10.1177/1557988320979257 ◽

2020 ◽

Vol 14 (6) ◽

pp. 155798832097925

Author(s):

Wellam F. Yu Ko ◽

John L. Oliffe ◽

Joan L. Bottorff

Keyword(s):

Prostate Cancer ◽

Return To Work ◽

Cancer Treatment ◽

Scoping Review ◽

Current Knowledge ◽

Significant Proportion ◽

Future Research ◽

Prostate Cancer Treatment ◽

Work Lives ◽

The Impact

Prostate cancer is the most common malignancy diagnosed in North American men. Although medical advances have improved survival rates, men treated for prostate cancer experience side-effects that can reduce their work capacity, increase financial stress, and affect their career and/or retirement plans. Working-age males comprise a significant proportion of new prostate cancer diagnoses. It is important, therefore, to understand the connections between prostate cancer and men’s work lives. This scoping review aimed to summarize and disseminate current research evidence about the impact of prostate cancer treatment on men’s work lives. Electronic databases were searched to identify peer-reviewed articles published between 2006 and 2020 that reported on the impact of prostate cancer treatment on men’s work. Following scoping review guidelines, 21 articles that met inclusion criteria were identified and analyzed. Evidence related to the impact of prostate cancer on work was grouped under three themes: (1) work outcomes after prostate cancer treatment; (2) return to work considerations, and (3) impact of prostate cancer treatment on men’s finances. Findings indicate that men’s return to work may be more gradual than expected after prostate cancer treatment. Some men may feel pressured by financial stressors and masculine ideals to resume work. Diverse factors including older age and social benefits appear to play a role in shaping men’s work-related plans after prostate cancer treatment. The findings provide direction for future research and offer clinicians a synthesis of current knowledge about the challenges men face in resuming work in the aftermath of prostate cancer treatment.

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