June 9, 2000

Coping With Prostate Cancer: A UCSD Cancer Center Study

By Jessica Baer and Rajni Banthia

The UCSD Cancer Center is now evaluating a program for its benefits in helping partners cope with the ensuing life changes and emotional ups and downs that can arise from a prostate cancer diagnosis. The impetus for this study came from a problem-solving therapy that was recently tested on mothers coping with their child's cancer at San Diego Children's Hospital. This program proved beneficial, and has been modified to evaluate its effect on adult couples dealing with prostate cancer. Presently, fifty of a possible 250 couples are enrolled in the study to aid the research team in its efforts to evaluate this program.

A prostate cancer diagnosis often brings with it many changes to a couple' relationship. Men will often turn to their partner for support and help in coping with their disease. The partner, also in distress over her husband's illness, is forced to handle many responsibilities that used to be taken care of by her partner. These abrupt changes, coupled with the grief of facing such a harrowing illness and the possibility of death, weigh very heavily on the partner.

Georgia Robins Sadler, Ph.D., Associate Director of Outreach at the UCSD Cancer Center, and also the head of the study for partners of men with prostate cancer notes, "Not only are they (the couples) dealing with an uncertain future, they also may be facing a temporary or permanent alteration in their roles. Perhaps for the first time in their relationship, the partner must become the principal decision-maker and may feel ill-prepared for such responsibilities as managing the family finances, negotiating health insurance claims, and so forth.

To face these changes, and to successfully cope with them, the partner may herself need support. Studies have shown that women are more apt to seek out support groups or psychotherapy during crises, thus they are the focus of the study. These therapies may possibly better prepare them for dealing with the challenges they face, and to also help them support their husband when he may need them the most.

To study the effect of the program, and to ensure an accurate scientific comparison, two groups will be established. Half of the participating couples will receive the standard supportive therapy while the other half will receive both the standard supportive therapy and the new program. During the program, over a course of eight weeks, trainers will meet with each couple, either at home or elsewhere if the couple desires, to work individually with the patient's partner. These free supportive care training sessions last for one hour each week. To help gauge the effectiveness of the program, couples in both groups will be asked to complete a questionnaire at the beginning of the study, at ten weeks, and then at six months. Once the couples have completed the third follow-up questionnaire, they will receive $100. Participants are encouraged to speak with their physicians should questions arise, because medical advice is not given to the couples by the researchers.

Different cultural groups react differently to stresses in life; therefore, to test the effectiveness of this program on each group, it is imperative that couples from all ethnic backgrounds participate. In 1999, 179,300 men were diagnosed with prostate cancer in the United States. That same year, 37,000 men died from the disease, making prostate cancer the second leading cause of cancer deaths in men, topped only by cancer of the lung.

Of the different Asian populations in the United States, in 1994, there was an incidence of prostate cancer in 88 of every 100,000 Japanese men, 70 in 100,000 Filipino and 46 in 100,000 Chinese men. African-American men have the greatest risk of developing prostate cancer. In 1994, 234 our of 100,000 African-American men were diagnosed with prostate cancer, compared to a figure of every 135 per 100,000 white men. Among Latinos, the incidence of prostate cancer was 89 in every 100,000 men and among Native American men, the incidence was 52.5 in every 100,000 men.

Fortunately, mortality rates for prostate cancer have recently begun to decline due to screening, increased early detection, and treatment of the cancer. This increase in survival rates leads to more men who are living with prostate cancer. This change of events makes the UCSD Cancer Center study all the more worthwhile.

Due to the fact that more men are living with prostate cancer, rather than dying from it, it would seem sensible to devise a way to improve the quality of life both for the patients and for the partners of men living with prostate cancer. Dr. Sadler has observed that "helping both the patient and their partner stay strong can improve the quality of life for the patient with prostate cancer, while helping to prevent the deterioration of his partner's health and well-being." This support would allow the partners to express their emotions and work towards solving their problems, rather than keeping them pent up inside, which could cause their health to deteriorate just as their husbands need them.

For more information regarding the study, please contact the UCSD Cancer Center at (858) 534-7611. The only criteria for participating in this study are that the patients must have been diagnosed with prostate cancer within the last eighteen months, be married or have a live-in partner, speak at least basic English and live in San Diego County. The stage of cancer, or chosen methods of treatment are not criteria for participating in this study. For more information regarding prostate cancer or any other cancer, please contact the National Cancer Institute's information line at 1-800-4-CANCER or the American Cancer Society at (858) 299-4200.

Jessica Baer is an undergraduate student at UCSD, majoring in microbiology, and is a Research Assistant to Dr. Georgia Robins Sadler, Associate Director at the UCSD Cancer Center.

Rajni Banthia is a Ph.D. student in the Joint Doctoral Program in Clinical Psychology at UCSD/SDSU and is a Research Assistant to Dr. Georgia Robins Sadler, Associate Director at the UCSD Cancer Center.

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