Introduction

Despite the potential side effects associated with treating prostate cancer, many men choose treatment over observation. The relative treatment benefits and harms to health related quality of life outcomes (HRQOL) remain poorly understood. In particular, there is a paucity of data detailing the differences in perceived treatment outcomes in African American (AA) and Hispanic men. We prospectively evaluated the functional and psychosocial effects of prostate cancer treatment in men and hypothesize that there may be differences in outcomes in Caucasian men vs. AA/Hispanic men.

Methods

We enrolled 105 men with recently diagnosed prostate cancer at our institution in an internet-based study which used validated questionnaires to longitudinally assess HRQOL domains such as sexual and urinary function, bowel function, anxiety, and depression, at 1, 3, 6, and 12 months following treatment. Linear mixed models were used to examine changes in self-reported measures at enrollment (pre-treatment) and at each post-treatment follow-up assessment. We focused our analysis on the 70 patients who chose radical prostatectomy or radiation therapy as treatment: 55 of these men were non-Hispanic white; 15 were AA or Hispanic.

Results

Despite significant declines in functional outcomes such as erectile function (P<.001 for both groups), anxiety was significantly lowered post-treatment in both groups. Significant reductions in anxiety were noted for Caucasian men (3.9 points , P<0.001) and were even greater for AA/Hispanic men (5.7 points, P<.001). When controlling for differences in income, marital status, education, and improvements in urinary score, the impact on anxiety remained significant (P<0.05) at 3, 6, and 12 months. Based on previous analyses, these improvements are both statistically and clinically significant.

Conclusions

We found significant reductions in anxiety after local therapy. While these reductions were found in all men, AA and Hispanic men reported a greater reduction in anxiety compared to Caucasians. This suggests that AA/Hispanic men may have a different perspective regarding prostate cancer and treatment outcomes. Further work is necessary to elucidate this difference in perspective.

Funding

none