Building Race-Specific Models for Disease Progression and Health-Related Quality of Life for Prostate Cancer Patients
Abstract
In 2014, an estimated 233,000 men will be newly diagnosed with prostate cancer and 29,480 men will die from this disease in the United States. The burden of the disease is particularly heavy among African Americans, who are 2.3 times more likely to die of prostate cancer than white Americans. Patients newly diagnosed with localized prostate cancer are often faced with difficult treatment decisions because there is no consensus among experts. Potential treatment options include surgery, radiation therapy, and monitoring cancer with the intention to treat when there is a sign of cancer progresses. Both surgery and radiation therapy are associated with treatment side effects that can have long-lasting impact on the quality of life. Because of the concerns of potential harms associated with over-treatment, active monitoring of cancer with the intention to treat when needed is recommended by several professional guidelines. Studies have shown that there are significant differences in clinical presentation and health-related quality of life between African American and white Americans. Understanding the potential outcomes following different treatment options is critical for making treatment decisions and providing optimal care. However, data specific to African American men are very limited and this may lead to sub-optimal care and lower quality of life. Our study goal is to provide data and tools that can be used to predict cancer events based on patients own race, tumor characteristics, and health status, so that patients can make treatment decisions based on sound scientific data and physicians can tailor prostate cancer therapy to African American patients to achieve optimal outcomes. The major objectives of this proposed study are summarized below. 1) Provide the most comprehensive data for the entire prostate cancer course and health-related quality of life at different stage of prostate cancer among African Americans. The Center for Prostate Disease Research has collected detailed clinical data for over 20 years and health-related quality of life data for more than 8 years among 3,200 African American patients and 13,000 Caucasian patients. It is uniquely suited to provide the most comprehensive race-specific data about prostate cancer. The findings of this study will address many commonly asked questions by patients diagnosed with prostate cancer such as "How long can I live?" and "If the prostate cancer is not treated, what parts of my body could be affected?" There is no expert consensus on how best to treat patients with early-stage prostate cancer or patients whose cancer has returned after initial therapy. However, one important consideration is how it might impact patient quality of life. Most patients will live for many years following a prostate cancer diagnosis, ultimately dying from other causes. Therefore, improving a patient s quality of life during the survivorship period is a critical important effort, as evidenced by the National Cancer Institute s Quality of Care Initiative aimed at ensuring that studies examining health-related quality of life receive sufficient attention. 2) Provide the first calculator to provide individualized risk estimates for African Americans. Prediction tools called "nomograms" can be used to estimate the probability of disease outcomes such as cancer progression and cancer survival. Such tools have been made available on the internet for use by both patients and clinicians. Advantages of these tools include the ability of a patient to use his own cancer characteristics to make tailored predictions about his individual disease outcomes. Currently, calculators that predict aggressive prostate cancer exist, but none has focused specifically on African American men. Very few tools are available for patients whose cancer has returned or patients who are being monitored without treatment. Moreover, none of these predictive tools has incorporated extensive cl
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510381
Entities
People
- Jennifer Cullen
Organizations
- Henry M. Jackson Foundation for the Advancement of Military Medicine
- United States Army