Treatment Decision Making in Localized Prostate Cancer: The Role of Functional Health Literacy and Cancer-Related Distress

Purpose

The proposed study will examine predictors of informed decision making in men considering treatment for localized prostate cancer. Specifically, we will evaluate the ability of functional health literacy and cancer-related anxiety to predict indices of effective decision making in a population of veterans with prostate cancer. Measure of prostate cancer knowledge, decisional conflict and eventual treatment choice will be used to assess these three components of effective decisions. Results from the proposed project will be used to support and develop interventions to improve decision making for men with localized prostate cancer by addressing the variables studied in this proposal: functional health literacy and cancer-related anxiety.

Findings

Participants completed the informed consent process and a battery of measures assessing the study variables described above. Study participation required approximately 60 minutes and participants received $40 for their time. Data collection is complete and analyses have begun. The final sample includes 64 men recently diagnosed with localized prostate cancer (PSA<50 TNM stages T1-2, N0, M0) who had not yet initiated treatment.  A total of 148 men were invited to participate in the present study. A total of 64 (43%) refused participation, either actively or passively (i.e., failure to return calls) and the remaining 20 (12%) were deemed ineligible, primarily due to treatment initiation.

Demographic and clinical information about the sample can be found in Tables 1 and 2. Data analysis is ongoing; however, preliminary results can be provided. Results partially supported Hypothesis 1. In univariate analyses, scores on a measure of prostate cancer knowledge were significantly associated with the SNS (r=.50, p <.01) and TOFHLA (r=.39, p<.01). Greater cancer-related anxiety was associated with greater decisional conflict (r=.30, p<.05).