African American prostate cancer survivors’ treatment decision-making and quality of life

ObjectiveTo examine African-American prostate cancer (PCa) survivors’ involvement in treatment decision-making (TDM), and examine the association between TDM and quality of life (QOL), using secondary data.MethodsAfrican-American PCa survivors (181) were recruited from the North Carolina Central Cancer Registry. Participants completed a cross-sectional survey that asked about their chosen cancer treatment, TDM factors, and PCa-specific QOL (using the Expanded Prostate Cancer Index Composite – EPIC). Multivariate analysis of covariance was conducted to determine the association between TDM and QOL, controlling for confounders.ResultsMost men reported being active (44.2%) or collaborative (38.1%) in TDM, while 14.4% preferred a passive role. Adjusting for marital status, education and treatment, passive patients reported somewhat better QOL compared to active patients in the following QOL domains: urinary summary (p = 0.04), urinary function (p = 0.01), and urinary incontinence (p = 0.03).ConclusionMost African-American PCa survivors preferred to be, and were, actively or collaboratively involved in TDM. However, those who preferred a passive role reported better PCa-specific QOL for the urinary domain compared to others.Practice implicationsIt is important to assess patients’ TDM preference. Patients’ QOL may differ by their TDM role, such that active patients may be more bothered by treatment side effects than other patients.