A STUDY ON THE EFFECT OF TX ON QUALITY OF LIFE FOR MEN WITH PROSTATE CA

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: This project will survey the "triad" of decision-makers (patient, spouse, and physician) to gain insight into how prostate cancer treatment decisions are made. By surveying the triad before treatment, we have the opportunity to identify influences at the time these decisions are made. RESEARCH PLAN: We will start by surveying the triad of decision-makers before treatment. This approach will give us the opportunity to identify influences at the time of the decision. Following treatment, or watchful waiting, we will survey patients and spouse to identify issues that, in retrospect, were irrelevant at the time of the decision was being made. We will determine whether these factors influence quality of life and treatment satisfaction. We will also evaluate the degree to which patient preferences, physicians' recommendations and other factors account for the considerable racial and socioeconomic disparity in the choices men make regarding their prostate cancer. METHODS: The objective of the baseline survey is to collect sociodemographic information, quality of life and co-morbidity, immediately prior to treatment. We will identify the sources and type of information patients and their family members receive. We will characterize interactions among decision-makers and identify influential factors in determining treatment preference. By measuring responses from all three decision-makers (patient, spouse/family member and physician), we can investigate the interactions between these individuals and how their individual preferences influence the treatment decision. The goal of the follow-up survey is to understand how preferences change, following treatment for patients and family members, and understand how these changes are associated with patient-specific outcomes including cancer specific and global health-related quality of life. The final instruments will utilize a variety of validated survey instruments and will develop questions, through a process of focus group interviews and pilot testing. CLINICAL RELEVANCE: This study will assess issues that limit persons from making informed choices. This study will also disentangle the influence of prostate cancer treatment choices from other factors on QOL and satisfaction with care. If these short term objectives are achieved, the long term goals are to help prostate cancer patients and their spouse or partner make well-informed decisions reflecting their values and expectations for treatment. The information from this study will be used as the basis for future intervention studies designed to improve decision-making, satisfaction with the treatment process and quality of life for men with localized prostate cancer.