Helping African American Prostate Cancer Survivors and Their Partners Cope With Challenges After Surgery for Prostate Cancer
Helping African American Prostate Cancer Survivors and Their Partners Cope With Challenges After Surgery for Prostate Cancer
RATIONALE: Telephone counseling after radical prostatectomy may help African American
 prostate cancer survivors and their intimate partners cope with the problems and challenges
 of surgery, and may reduce distress and improve quality of life. It is not yet known which
 counseling and education program is more effective in helping prostate cancer survivors and
 their partners.

 PURPOSE: This randomized clinical trial is studying effective ways to help African American
 prostate cancer survivors and their partners cope with challenges after surgery for
 early-stage prostate cancer.
OBJECTIVES:

 Primary

 -  To develop more effective ways to help both African American prostate cancer survivors
 and their intimate partners cope with the problems and challenges experienced after
 radical prostatectomy for prostate cancer.

 -  To evaluate the efficacy of a new, telephone-based, partner-assisted, coping skills
 training (CST) protocol for reducing survivor and partner disease-related and overall
 distress, addressing cancer-related strain and overall distress in survivors' intimate
 partners, and improving relationship quality between survivors and partners by enhancing
 intimacy and adjustment within the relationship.

 Secondary

 -  To identify for whom the intervention may be more or less efficacious by exploring the
 association between initial relationship functioning (i.e., dyadic adjustment scores
 reported by survivors and partners) and survivor outcomes and between initial
 relationship functioning and partner outcomes.

 OUTLINE: Survivors are stratified according to symptom severity (low vs moderate vs high) and
 clinical risk category (low vs moderate vs high). Survivor/partner dyads are randomized to 1
 of 3 intervention arms.

 -  Arm I (Partner-assisted coping skills training [PA-CST]): Survivor/partner dyads undergo
 a telephone-based, culturally sensitive PA-CST intervention in six weekly telephone
 sessions (60-minutes each) over 8 weeks, conducted by African American doctoral level
 clinical psychologists knowledgeable about prostate cancer and experienced in CST and
 cancer education. During these sessions, participants are trained in a variety of
 cognitive and behavioral skills to manage symptom-related distress and to improve their
 quality of life after prostate cancer treatment. Among these skills are strategies for
 communication (i.e., effective speaking and listening); behavioral coping methods (i.e.,
 activity pacing, applied relaxation techniques, and goal setting to increase pleasant
 activities); and skills for managing negative mood and reducing emotional stress.
 Participants also receive guidance in working cooperatively with their partners to
 improve symptom management, including joint practicing of coping skills and
 problem-solving strategies.

 -  Arm II (Cancer education): Survivor/partner dyads undergo a telephone-based, culturally
 sensitive cancer education intervention in six weekly telephone sessions (60 minutes
 each) over 8 weeks, conducted by African American doctoral level clinical psychologists
 knowledgeable about prostate cancer and experienced in CST and cancer education. During
 the sessions, participants are educated about symptoms commonly experienced after
 prostatectomy (i.e., erectile dysfunction, urinary incontinence, nutrition, bowel
 problems, and fatigue) and medical treatment options for these symptoms. Participants
 also receive written materials about these information.

 -  Arm III (Wait-list control): Survivor/partner dyads receive usual care and are placed on
 a wait-list. After completing the study, survivors and their partners have the option of
 participating in either the CST or cancer education interventions.

 All participants complete questionnaires at baseline, right after intervention (2 months),
 and 3 months after intervention (5 months). Survivors complete questionnaires over
 approximately 28 minutes to measure symptom distress/severity, depressed mood, quality of
 life, self-efficacy for symptom management, relationship quality, and coping strategies.
 Partners complete questionnaires over approximately 17 minutes to measure caregiver strain,
 depressed mood, partners' self-efficacy for symptom control, relationship quality, and coping
 strategies. At each evaluation, physicians provide ratings of illness severity, documentation
 of medical treatments for cancer and symptom management, and frequency of clinic visits for
 each survivor.
DISEASE CHARACTERISTICS:

 -  African American prostate cancer survivor

 -  Diagnosis of early-stage prostate cancer

 -  Stage T1-T3 disease

 -  No regional or metastatic prostate cancer

 -  Underwent radical prostatectomy as the primary treatment for prostate cancer
 within the past 2 years

 -  Prior adjunctive radiotherapy secondary to surgery allowed

 -  No radiotherapy (i.e., external beam radiation or brachytherapy) as
 primary form of treatment

 -  Intimate partner of cancer survivor

 -  Spouse or any cohabiting intimate partner identified by the survivor

 -  Same sex partners and partners of all ethnicities allowed

 PATIENT CHARACTERISTICS:

 -  No dementia or unstable psychiatric condition

 -  No significant hearing impairment

 -  Fluent in English

 PRIOR CONCURRENT THERAPY:

 -  See Disease Characteristics