The recent outbreak of infections and the pandemic caused by SARS-CoV-2 represent one of the most severe threats to human health in more than a century. Emerging data from the United States and elsewhere suggest that the disease is more severe in men. Knowledge gained, and lessons learned, from studies of the biological interactions and molecular links that may explain the reasons for the greater severity of disease in men, and specifically in the age group at risk for prostate cancer, will lead to better management of COVID-19 in prostate cancer patients. Such information will be indispensable in the current and post-pandemic scenarios.

Purpose Although improvements in perioperative care have decreased surgical morbidity following radical cystectomy for muscle invasive bladder cancer (MIBC), treatment side effects still have a negative impact on patients’ quality of life (QOL). This study examines patients’ unmet needs along the illness trajectory. Methods and Materials Thirty patients (26.7% women) treated with cystectomy and urinary diversion for MIBC participated in the study. Patients were recruited from the Department of Urology at Mount Sinai and through advertisements on the Bladder Cancer Advocacy Network website between December, 2011 and September, 2012. Data were collected through individual interviews. The interviews were audio-taped and transcribed. Qualitative analyses of transcribed data were used to explore key unmet needs. Results At time of diagnosis, unmet informational needs were predominant, consisting of insufficient discussions of these topics: urinary diversion options and their side-effects, self-care, recovery process, and medical insurance. Unmet psychological needs related to depression and worries about changes in body image and sexual function were reported. Post-surgical unmet needs revolved around medical (e.g., pain, bowel dysfunction), and instrumental needs (e.g., need of support with use of stomal appliances, catheters, and incontinence). During survivorship (i.e., from 6 to 72 months following surgery), unmet needs centered around psychological (i.e., depression, poor body image, sexual dysfunction) and instrumental support (e.g., difficulty adjusting to changes in daily-living). Conclusions Meeting patients’ needs is imperative to ensure patients’ adequate involvement in their healthcare, and to enhance post-surgical QOL. An effective support provision plan should follow changes in patients’ needs.

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We examined decisional regret among prostate cancer patients and its association with disease-specific quality of life. Patients (N = 793) completed questionnaires at diagnosis, at 6 months, and 12 months thereafter. Although levels of decisional regret were low, regret increased significantly between 6 and 12 months after diagnosis. The increase was substantial for patients treated with prostatectomy compared to patients treated with external beam radiation or brachytherapy. Cross-sectional, significant, and positive associations among regret, activity limitation attributed to urinary dysfunction, and bother with sexual and urinary dysfunction emerged. Longitudinally, the change in the level of regret was significantly associated with treatment modality and with the change in bother with sexual dysfunction over the first 6 months after diagnosis. Extensive discussions about disease-specific quality of life should be included when physicians counsel patients about treatment options.

This longitudinal study investigates whether finding benefits in cancer can be predicted by assimilative and accommodative coping strategies, general self-efficacy, and received social support. Self-efficacy and social support were measured 1 month after cancer surgery, coping strategies 6 months after surgery, and benefit finding 12 months after surgery. Ninety-seven patients with cancer completed measures of benefit finding and its predictors. Four dimensions of benefit were distinguished: personal growth, acceptance of life imperfection, sensitivity to others, and improved family relationships. Path analyses revealed that self-efficacy beliefs had direct effects on personal growth, acceptance of life imperfection, and increased sensitivity to others, whereas received social support affected improved family relationships. Effects of social support were unmediated. The effects of self-efficacy on acceptance of life imperfection were mediated by accommodative coping strategies, but the effects of self-efficacy on personal growth and increased sensitivity to others were mediated by assimilative coping strategies. Resources and coping strategies predicted specific dimensions of benefit finding.

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BackgroundProstate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients’ treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts.Objectives(1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants’ information-seeking styles on study outcomes.MethodsParticipants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient’s information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference).ResultsThe PIES program was well accepted by patients and did not interfere with the clinical routine. About 79% of eligible patients (72/91) completed the pre- and post-PIES intervention assessments. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices, higher levels of helpfulness of the information they received in making a treatment decision, and that the information they received was emotionally reassuring. Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options, were less anxious about their treatment choices, and thought the information they received was clear (P < .05). Tailoring PIES information to information-seeking style was not related to decision-making variables.ConclusionsThis pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer. PIES improved key decision-making pr...

Racial disparities in prostate cancer have not been well characterized on a genomic level. Here we show the results of a multi-institutional retrospective analysis of 1,152 patients (596 African-American men (AAM) and 556 European-American men (EAM)) who underwent radical prostatectomy. Comparative analyses between the race groups were conducted at the clinical, genomic, pathway, molecular subtype, and prognostic levels. The EAM group had increased ERG (P < 0.001) and ETS (P = 0.02) expression, decreased SPINK1 expression (P < 0.001), and basal-like (P < 0.001) molecular subtypes. After adjusting for confounders, the AAM group was associated with higher expression of CRYBB2, GSTM3, and inflammation genes (IL33, IFNG, CCL4, CD3, ICOSLG), and lower expression of mismatch repair genes (MSH2, MSH6) (p < 0.001 for all). At the pathway level, the AAM group had higher expression of genes sets related to the immune response, apoptosis, hypoxia, and reactive oxygen species. EAM group was associated with higher levels of fatty acid metabolism, DNA repair, and WNT/beta-catenin signaling. Based on cell lines data, AAM were predicted to have higher potential response to DNA damage. In conclusion, biological characteristics of prostate tumor were substantially different in AAM when compared to EAM.