Stability of self-reported family history of prostate cancer among African American men

The genome-wide search for the prostate cancer gene holds the promise of the availability of prostate cancer susceptibility testing in the near future. When this occurs, self-reported history of prostate cancer will be critical in determining who is eligible for cancer susceptibility testing. Little attention has been given to the reliability of self-reported family history of prostate cancer, particularly in African American men. This correlational study measured the stability of self-reported family history of prostate cancer over a one-year time period (between 1997 and 1998) with 96 African American men from a southern state. The men were asked on two separate occasions, 1 year apart, "Have any of your men blood relatives ever had prostate cancer?" The question had a prior test-retest reliability of 0.85 over a 2-week period. Forty-eight percent of the men changed their answers on the second administration. Men most likely to change their answers were low-income men and men who did not participate in a free prostate cancer screening. This research highlights the need for public genetic education and the recognition by health professionals that self-reported family history of cancer is a variable that changes as families have increased awareness and communication concerning family history of cancer.     

Predictors of prostate cancer screening intention among older men in Jordan

Intention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.     

Perceived barriers to prostate cancer screenings among middle-aged men in north-eastern Germany

ABSTRACT Objectives: Prostate cancer ranks high in mortality. Only 18% of men entitled for screenings take advantage of this. Social‐cognitive models of health psychology describe and predict health behavior. This study investigates what barriers men perceive that impede the utilization of cancer screenings. Design and Sample: Semistructured interviews were conducted in 2 general practices and 3 hospital wards. One hundred and seventy‐eight men over 45 years were addressed; 64 utilized cancer screenings regularly, 3 had a diagnosis of prostate cancer, and 18 declined participation. Measures: Content analyses were conducted with 83 interviews. The interview tapped into the following domains: barriers, risk perception, outcome expectancies, self‐efficacy, and intentions. Results: 57 men regarded their health as very important, while 47 had never utilized cancer screenings. Barriers were divided into emotional/cognitive versus organizational/structural. Sixty‐four men did not utilize cancer screenings because of lack of symptoms, 22 feared a positive result, 20 had more pertinent health issues, and 18 assumed that their physicians would screen for cancer “automatically.” Conclusions: Mainly emotional/cognitive barriers were seen as important for nonutilization, especially the absence of symptoms. Following the reasoning of social‐cognitive models, a first step to enhance utilization rates would be to enhance risk perception.     

Quality of life among men treated with brachytherapy for prostate cancer

Brachytherapy, the implantation of permanent radiation sources into the transperineal area, is being used with increasing frequency as treatment for localized prostate cancer. In this study, men undergoing brachytherapy evaluated their quality of life (QoL) before and after treatment. Brachytherapy affects QoL within the domains of emotional well-being and specific prostate concerns. Knowledge of the treatment effects on QoL will assist nursing staff working with patients faced with treatment decisions for prostate cancer.     

Using the health belief model in understanding prostate cancer in African American men.

Research studies show that African American men or more likely to develop and die of prostate cancer than any other ethnic group. The disparity is partially associated with the motivators of behaviors in African American men. In particular, perception of outcomes in relationship to behavioral performances influences whether a task will be initiated. This paper examines prostate cancer in African American men using components of the Health Belief Model. Implications, for professional nurses in designing interventions to encourage early screening and treatment for prostate cancer, are included.     

Reducing prostate cancer morbidity and mortality in African American men: issues and challenges

Prostate cancer is the most commonly diagnosed cancer in men in the United States. It disproportionately affects African American men when compared to other ethnic groups. African American men are two to three times more likely to die of prostate cancer than white men. The reasons for the disparity remain unclear, but several factors may be involved, such as age, race, nationality, nutrition, exercise, and family history of cancer. Detection of prostate cancer in high-risk African Americans is important but continues to be controversial. This article reviews the current issues and challenges regarding prostate cancer in African American men. Nurses play a vital role in the health care and education of patients; therefore, they must be aware of the issues.     

Quality of life among men treated with radiation therapy for prostate cancer

Prostate cancer continues to affect an increasing number of men in the United States. When diagnosed, these men may not have access to information that differentiates the long-term outcomes of one method of treatment from another. This study evaluated the impact of external beam radiation on several domains of quality of life, including physical, social/family, emotional, and functional well-being domains.     

Disparities in prostate cancer in African American men: what primary care physicians can do

African American men have a higher incidence of prostate cancer than white men, and also a higher rate of death due to prostate cancer. Although both biologic and socioeconomic factors may be to blame, better screening in this population may help to close the gap.     

Knowledge of the limitations associated with prostate cancer screening among low-income men

This correlational pilot study measured limitations of prostate cancer screening, using a revised Knowledge of Prostate Cancer Questionnaire. Knowledge in 81 low-income men is reported. The Knowledge About Prostate Cancer Screening Questionnaire consists of 12 questions, with scores ranging from 0 to 12. Concepts measured include limitations, symptoms, risk factors, and screening age guidelines. The Total Knowledge Score had a mean of 6.60, with a standard deviation of 3.00, indicating that knowledge was low. Half of the men knew that "some treatments for prostate cancer can make it harder for men to control their urine." More than half of the men knew that, "some treatments for prostate cancer can cause problems with a man's ability to have sex." Married men, low-income men, and Caucasian men had significantly lower Total Knowledge Scores than unmarried, higher income, and African American men. Implications for practice and research are discussed.     

Clinical efficacy of prostate cancer detection using power doppler imaging in American and Japanese men

PURPOSE: The aim of this study was to compare the detection rates of tumor vascular flow as measured by power Doppler imaging (PDI) in 2 populations and to determine whether PDI can reduce the number of unnecessary prostate biopsies in men with serum prostate-specific antigen (PSA) concentrations less than 10.1 ng/ml. METHODS: The patient populations were Japanese (group 1) and American (group 2) men with either serum PSA concentrations of 4.1-10.0 ng/ml or abnormal findings on digital rectal examination (DRE) plus PSA concentrations less than 4.1 ng/ml. We compared the overall diagnostic accuracy of DRE, gray-scale transrectal sonography (TRUS), and PDI between the 2 groups. RESULTS: In total, 275 men were studied, 154 in group 1 and 121 in group 2. Cancer was identified in 27% of men in group 1 and in 60% of group 2. Men with cancer in both groups differed significantly in age, peripheral zone volume, and mean number of positive biopsy cores. The sensitivity and specificity of PDI in group 2 were significantly inferior to those in group 1. The negative predictive value (NPV) of PDI was significantly higher for group 1 than for group 2. The NPV of PDI in group 1 was equivalent to that for the combination of DRE and TRUS, whereas the NPV for PDI in group 2 was significantly inferior to that of DRE and TRUS.CONCLUSIONS: Tumor vascularity could be detected by PDI more effectively in Japanese men with cancer than in American men with cancer. We hypothesize that this difference was a result of larger cancer volumes and smaller prostates in the Japanese men. PDI did not provide any performance advantage over DRE and TRUS in avoiding unnecessary biopsies.     

Effect of treatment on quality of life among men with clinically localized prostate cancer

BACKGROUND: Quality-of-life outcomes are an important consideration for patients evaluating therapeutic options for localized prostate cancer. OBJECTIVES: The objective of this study was to describe the effect of treatment choice on change in health-related quality of life (HRQOL) among men with clinically localized prostate cancer. RESEARCH DESIGN: This was a prospective observational study. SUBJECTS: The study subjects were 122 men with clinically localized adenocarcinoma of the prostate. Forty-two subjects (34%) underwent radical prostatectomy, 51 (42%) underwent radiation therapy, and 29 (24%) were followed with expectant management. MEASURES: The University of California at Los Angeles Prostate Cancer Quality of Life Inde- and the Medical Outcomes Study Short Form-36 were administered before and 3 and 12 months after initial treatment. The study used an analysis of covariance model adjusted for baseline differences in clinical and demographic factors. RESULTS: Men who underwent radical prostatectomy experienced significant declines in urinary and sexual function and bother that persisted at 12 months after treatment. Men treated with radiation therapy experienced smaller but significant declines in sexual function and a decline in social function. Expectant management patients did not have a significant change in disease-targeted or generic HRQOL domains. Differential rates of change in urinary and sexual function between treatment groups persisted after adjustment for differences in pretreatment clinical and demographic factors. CONCLUSIONS: Men undergoing radical prostatectomy have substantial declines in urinary and sexual function, and men undergoing radiotherapy have declines in sexual function. Men undergoing expectant management have no change in disease-specific or general HRQOL in the first year after treatment.     

Black men are dying from prostate cancer

Prostate cancer is the most frequently diagnosed cancer in the United States, accounting for 33% of all cancer cases among men (American Cancer Society, 2004). In the United States the number of new cases of prostate cancer was estimated at 230,110 and 29,900 will die (American Cancer Society, 2004). It is anticipated that these numbers will continue to grow despite effective treatment regiments. Black men (African-American) are 2.5 times more likely to die of prostate cancer than White men (Peters, 2005). Recent studies suggest genetics, diet, knowledge, and socioeconomic status as contributory factors, however, there appears to be more to it.     

上海地区汉族人群LMTK2与MSMB基因多态性与前列腺癌的易感性

目的:探讨中国上海地区汉族人群中LMTK2与MSMB基因多态性与前列腺癌遗传易感性的关系.方法:采用病例对照研究,提取200例前列腺癌患者(病例组)和200例非前列腺癌健康人(对照组)外周血中基因组DNA,应用ABI 3730 XL测序仪分析病例组和对照组的LMTK2基因rs6465657位点以及MSMB基因rs10993994位点的多态性,比较不同基因型与前列腺癌易感性的关系.结果:MSMB基因rs10993994位点密码子T/C基因型的个体其前列腺癌发病风险是C/C基因型的1.62倍(OR=1.62,95%可信区间:1.12～2.27),携带MSMB基因rs10993994位点等位基因T(T/T,T/C)的个体发生前列腺癌的风险性是C/C基因型的0.96倍(OR=0.96,95%可信区间:0.82～1.11).LMTK2基因rs6465657位点密码子C/C基因型的个体其前列腺癌发病风险与T/C基因型无明显差异.结论:中国上海地区汉族人群中MSMB基因rs10993994位点多态性可能对前列腺癌遗传易感性有影响,而LMTK2基因rs6465657位点对前列腺癌遗传易感性无明显影响.     

Benefits, barriers, sources of influence, and prostate cancer screening among rural men

ABSTRACT Objective: The objective of this study was to explore 3 research questions: (1) What are the perceived benefits of screening for prostate cancer (PC)? (2) What are the perceived barriers to screening for PC? and (3) Is there an association with perceived benefits or perceived barriers and participants' reported source of influence related to prostate cancer screening (PCS) decisions? Design and Sample: A nonexperimental exploratory design was used for the study. Sample included 94 rural‐dwelling male participants aged 40 and older. Measures: The instruments used included an adapted version of Champion's (1999) revised Health Belief Model scale and a researcher‐developed demographic and PCS patterns form. Results: Both benefits and barriers were significantly associated with PCS and sources of influence. Health care providers and family were highly reported, at 81.8% and 59.5%, respectively, as sources of influence regarding PCS decisions. Conclusions: In this primarily African American sample, significant barriers to PCS among rural men were indentifed. PC health education may need to include family, whom study participants highly reported as a source of influence regarding their PCS decisions.     

Health care seeking among Mexican American men.

This focused ethnography explored health care seeking beliefs and behaviors of Mexican American men living in south central Washington State. Data collection included interviews with 36 research participants living in the community, participant observation in the research setting, and examination of ethnographic documents and cultural artifacts. Four major themes were identified: the identity of manhood dictates health care seeking, health means being able to be a man by fulfilling cultural obligations, illness means not being able to be a man, and men seek health care when their manhood is threatened or impaired. Machismo, the cultural concept of manliness, persisted among men despite the level of acculturation and other factors. Women influenced men's health care seeking behaviors. To fulfill their obligations, men must stay healthy and seek care when needed. Knowing when and why men do not seek health care enables nurses to better understand and serve the Mexican American community.     

Support for men newly diagnosed with prostate cancer

This article discusses the findings of a multi-hospital satisfaction survey of men with newly diagnosed prostate cancer. The survey was designed to enable direct comparison with a previously published satisfaction survey conducted by the Prostate Cancer Charity. Results showed that the nurse specialist is a valuable resource for patients and has an important role in maintaining standards of care.