UroToday.com - A report from the Department of Psychiatry, Memorial Sloan-Kettering Cancer Center suggests that African-American (AA) men with prostate cancer (CaP) have a sense of greater emotional well being and lower incidence of clinically significant depressive symptoms compared with Caucasian men.

The study was undertaken as AA men have a greater likelihood of being diagnosed with advanced CaP and a 2.3 fold greater likelihood of dying from CaP compared with Caucasian men. AA men are also less likely to have appropriate knowledge of the risk of CaP or to undergo a digital rectal examination. The study used two separate patient cohorts, both evaluating the quality of life, distress, anxiety, and depression in men with early and late-stage CaP. One database was from 385 men visiting doctors' offices throughout the US. Average age was 71 years and 86% were Caucasian, 10% AA. Half had early stage disease and the average time from diagnosis was 4.4 years. College education or above was documented in 42%, and 83% were married. In the second database, 376 men were assessed from MSKCC clinics. Average age was 66 years, 89% were Caucasian, 6% AA, 45% had early stage disease, and 5.2 years had eclipsed since diagnosis. Of these men, 73% had a college degree or higher and 84% were married. Data from the following questionnaires were analyzed; The Distress Thermometer, the HADS, the Functional Assessment of Cancer Therapy (FACT-G), and a demographics questionnaire. These questionnaires assessed distress, depression, anxiety, and emotional well-being.

The databases were combined for the analysis of the 686 total subjects. There was no significant difference in demographic variables, disease stage, time since diagnosis, or marital status. AA men were younger (63 vs. 69 years), and a lower percentage had completed a college education. AA men generally reported levels of anxiety, distress, depression and emotional well-being similar to Caucasian men with CaP. When matching AA and Caucasian men for age, education and stage of disease, AA men still displayed similar levels of distress as compared with Caucasian men. However, AA men reported significantly higher emotional well-being compared with Caucasian men.

Nelson CJ, Balk EM, Roth AJ
Psychooncology. 2010 Jan 14. Epub ahead of print.

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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