Blacks with Recurrent Prostate Cancer More Likely To Regret Treatment
Racial differences in treatment regret more pronounced among those without sexual problems.
Among men who experience recurrence of prostate cancer (PCa), blacks may be more likely than non-blacks to regret being treated, according to a new study.
Brandon Arvin Virgil Mahal, a 4th-year medical student at Harvard Medical School and a research fellow at the Dana-Farber Cancer Institute, both in Boston, and colleagues, studied 484 men (78 black, 406 non-black) who experienced biochemical recurrence of PCa after radical prostatectomy, external beam radiotherapy, and brachytherapy.
Results showed that 21.8% of black men had treatment regret compared with 12.6% of non-black men, a difference that translated into a significant 1.9 times increased likelihood of treatment regret among black men, Dr. Mahal's group reported online ahead of print in Prostate Cancer and Prostatic Diseases.
After adjusting for treatment type, health literacy, sociodemographic factors, and patient-reported complications after treatment, however, black race no longer was significantly associated with an increased likelihood of treatment regret.
In addition, the study found that racial differences in treatment regret may be mitigated by the presence of sexual problems after treatment. Among men with sexual problems after treatment, the researchers observed no significant difference in the proportion of blacks and non-blacks expressing treatment regret.
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Among men without sexual problems after treatment, however, 26.7% of blacks expressed treatment regret compared with 8.4% of non-blacks, a difference that translated into a significant 4.7-fold increased odds of treatment regret among blacks, in adjusted analyses.
The researchers say they believe their findings support the notion that sexual dysfunction is a ubiquitous concern following PCa treatment among all men regardless of race “and in the presence of sexual issues after treatment, there are no detectable differences in the rate of regret across races.”
“Treating physicians should ensure that patients are fully apprised of the pros and cons of all treatment options in a culturally competent and relevant manner in order to reduce the risk of subsequent regret,” the authors concluded.