Examining Cultural Factors that Influence Treatment Decisions: a Pilot Study of Latino Men with Cancer

Abstract

The objective of this study was to explore beliefs and treatment decisions of foreign-born Latino men from Cuba, Mexico, Colombia, and Venezuela, who have been diagnosed with cancer and who live in Central Florida, USA. Experiences related to knowledge of diagnosis, treatment decisions, communication with health providers, family involvement, and advance care planning (ACP) discussions following the diagnosis of cancer are central to this study. This study used qualitative in-depth semi-structured interviews and thematic analysis. The interviews were conducted with 15 Latino men who have been diagnosed with cancer within the past 5 years and who reside in the community. The interviews were conducted and transcribed in Spanish and then translated into English. The median age was 55.4 years. Nine Latino men had prostate cancer, two had brain cancer, two had colorectal cancer, and two had lung cancer. Emerging themes involved the suddenness of the diagnosis, fear of dying, expectations of diagnosis-related communication, reliance on physicians for treatment decisions, limited information pertaining to ACP, family support, and role changes. Latino men's limited knowledge of cancer diagnosis and treatment options coupled with their fear led them to immediately believe that they were going to die. Knowledge gaps regarding diagnosis-related communication, treatment decisions, and ACP varied among the men. The forthright diagnosis communication and the expectation to engage in decision making are contrary to Latinos men's beliefs of reliance on health providers decisions. The findings contribute to understanding Latino men's beliefs about a cancer diagnosis and treatment decisions.

Racial and Ethnic Differences in Prostate Cancer Survivors’ Perceived Engagement in Treatment Decision-Making

“…To our knowledge, this is the first study to examine racial and ethnic disparities in patients’ perceived engagement in prostate cancer treatment decision-making, and to compare across these racial/ethnic groups the specific demographic and health characteristics associated with treatment decision engagement. Most relevant studies only compare non-Latino White prostate cancer patients to African American or “nonwhite” patients [21–24]. This study adds to the sparse data on Latino and Asian American prostate cancer patients’ engagement in prostate cancer treatment decision-making, and highlights the need for future research on cultural factors not measured in this study (e.g., patients’ language preference in clinical encounters, family involvement, trust, etc.).…”

“…Unfortunately, there is limited knowledge about prostate cancer patients’ perceived engagement in shared decision-making for prostate cancer treatment, particularly among a diverse population of racial and ethnic minorities, as most studies only compare African American and White prostate cancer patients [6,8,21–24]. Little is known about how other groups, such as Latinos and Asian Americans experience prostate cancer shared decision making.…”

“…Little is known about how other groups, such as Latinos and Asian Americans experience prostate cancer shared decision making. These groups experience greater challenges, as cultural as well as linguistic factors may affect their interactions with the medical environment [21]. There is increasing evidence that many patients want to be involved in treatment decisions [15,25]; however, non-cancer studies indicate that racial/ethnic minorities report less involvement in treatment decision-making [26].…”

Cancer Health Literacy Test-30-Spanish (CHLT-30-DKspa), a New Spanish-Language Version of the Cancer Health Literacy Test (CHLT-30) for Spanish-Speaking Latinos

“…Some of them talked about people they knew who had cancer and after the surgery to “cut” the cancer, it was instead spread into the blood contaminating all the body. Although it could be argued that answers to this item are affected by low literacy level of respondents, this issue is commonly considered in the literature as a “myth” or “belief” that is generally based on individuals experiences and that may be reinforced by conflicting information sources (American Cancer Society, 2014; Goldfarb & Ben-Eliyahu, 2006-2007; CANCERactive.com; Scutti, 2015) The strength of the belief that cancer can be spread by surgery and its influence in treatment decisions have been reported in several studies (Dumenci et al, 2014; James, Daley & Greiner, 2011; Luo, Spolverato, Johnston, Haider, & Pawlik, 2015; Carrion, Nedjat-Haiem & Marquez, 2013; DeLisser, Keirns, Clinton & Margolis, 2009), and is well documented in the application of the Health Belief Model to study cancer screening behaviors (Champion & Skinner, 2008). …”

Understanding the supportive care needs of Hispanic men cancer survivors

“…Male cancer survivors, in general, and Hispanic men especially, are underrepresented in the psychosocial and survivorship literature (Carrion, Nedjat-Haiem, and Marquez 2013), yet their unique needs must be addressed in order to ensure ideal supportive care.…”