Fox Chase Researchers Link Lower Income and Levels of Health Literacy to Problems Coping After Treatment for Prostate Cancer

PHILADELPHIA (October 6, 2020)—In a recent study, researchers at Fox Chase Cancer Center found individuals with lower health literacy or income reported more practical issues and problems with coping following localized prostate cancer treatment.

“After treatment, there are a number of challenges in the survivorship stage. It’s like a black hole,” said Suzanne M. Miller, PhD, one of the study authors and professor in the Cancer Prevention and Control Program at Fox Chase.

“Despite the fact that there’s close to 100% survivorship, they have enormous psychological and financial toxicity issues. We designed an online coping intervention for prostate cancer survivors making the transition from treatment into survivorship,” Miller added.

“We wanted to see what was important for clinicians to look for as these patients are re-entering into these new roles in their lives,” said Erin K. Tagai, PhD, MPH, another study author and a postdoctoral fellow in Miller’s lab.

The online survey consisted of assessments in self-efficacy for re-entry and looked at factors like maintaining relationships and symptom management. It also included assessments for medical interactions and practical concerns such as insurance and exercise.

“A lot of survivorship research is on long-term survivorship, which is great,” said Tagai. “But these participants are within one year of completing treatment, so we can really identify little signals that we can screen for before we let them go. This helps our doctors fine tune those more social aspects of patients’ lives and help them with that.”

The study found participants with lower health literacy or income or with depressive symptoms had lower self-efficacy for re-entry, more negative interactions with medical providers, and more practical concerns. Non-Hispanic white participants reported greater readiness compared with all other races, according to researchers.

“This really speaks to the disparities in the health system and people entering it, as well as the need to address it,” said Miller. “Because active surveillance is such a useful treatment, we’re now also doing a decision-making aid and testing it around treatment decision making. We’re trying to do it in a way that keeps low health literacy in mind.”

The researchers said future studies are needed to help providers identify and support individuals at risk for poorer coping and greater practical concerns after treatment completion. The study, “Social and Medical Risk Factors Associated With Supportive Needs in the First Year Following Localized Prostate Cancer Treatment,” was published in The Journal of Cancer Survivorship.

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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