African-American survivors of prostate cancer: a meta-synthesis of qualitative studies

Abstract

Purpose

The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences.

Method

We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare’s meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program.

Results

This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme.

Conclusion

Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional.

Implications for cancer survivors

This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. 1.

    American Cancer Society. Cancer-facts-and-figures. Atlanta, GA, 2019.

  2. 2.

    Barocas DA, Grubb R III, Black A, Penson DF, Fowke JH, Andriole G, et al. Association between race and follow-up diagnostic care after a positive prostate cancer screening test in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer. 2013;119(12):2223–9.

    PubMed  Google Scholar 

  3. 3.

    Stokes WA, Hendrix LH, Royce TJ, Allen IM, Godley PA, Wang AZ, et al. Racial differences in time from prostate cancer diagnosis to treatment initiation: a population-based study. Cancer. 2013;119(13):2486–93.

    PubMed  Google Scholar 

  4. 4.

    Mahal BA, Aizer AA, Ziehr DR, Hyatt AS, Sammon JD, Schmid M, et al. Trends in disparate treatment of African American men with localized prostate cancer across National Comprehensive Cancer Network risk groups. Urology. 2014;84(2):386–92.

    PubMed  Google Scholar 

  5. 5.

    Mullins CD, Onukwugha E, Bikov K, Seal B, Hussain A. Health disparities in staging of SEER-Medicare prostate cancer patients in the United States. Urology. 2010;76(3):566–72.

    PubMed  PubMed Central  Google Scholar 

  6. 6.

    Litwin MS, Melmed GY, Nakazon T. Life after radical prostatectomy: a longitudinal study. J Urol. 2001;166(2):587–92.

    CAS  PubMed  Google Scholar 

  7. 7.

    Eton DT, Lepore SJ, Helgeson VSJC. Early quality of life in patients with localized prostate carcinoma: an examination of treatment-related, demographic, and psychosocial factors. Cancer. 2001;92(6):1451–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Johnson TK, Gilliland FD, Hoffman RM, Deapen D, Penson DF, Stanford JL, et al. Racial/ethnic differences in functional outcomes in the 5 years after diagnosis of localized prostate cancer. J Clin Oncol. 2004;22(20):4193–201.

    PubMed  Google Scholar 

  9. 9.

    Darwish-Yassine M, Berenji M, Wing D, Copeland G, Demers RY, Garlinghouse C, et al. Evaluating long-term patient-centered outcomes following prostate cancer treatment: findings from the Michigan Prostate Cancer Survivor study. J Cancer Surviv. 2014;8(1):121–30.

    PubMed  Google Scholar 

  10. 10.

    Resnick MJ, Koyama T, Fan KH, Albertsen PC, Goodman M, Hamilton AS, et al. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013;368(5):436–45.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Traeger L, et al. Race by sex differences in depression symptoms and psychosocial service use among non-Hispanic black and white patients with lung cancer. J Clin Oncol. 2014;32(2):107.

    PubMed  Google Scholar 

  12. 12.

    Watts S, et al. Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates. BMJ Open. 2014;4(3). https://doi.org/10.1136/bmjopen-2013-003901.

  13. 13.

    Zhang AY, Gary F, Zhu H. What precipitates depression in African-American cancer patients? Triggers and stressors. Palliat Support Care. 2012;10(4):279–86.

    PubMed  Google Scholar 

  14. 14.

    Orom H, Nelson CJ, Underwood W III, Homish DL, Kapoor DA. Factors associated with emotional distress in newly diagnosed prostate cancer patients. Psychooncology. 2015;24(11):1416–22.

    PubMed  PubMed Central  Google Scholar 

  15. 15.

    Jayadevappa R, Malkowicz SB, Chhatre S, Johnson JC, Gallo JJ. The burden of depression in prostate cancer. Psychooncology. 2012;21(12):1338–45.

    PubMed  Google Scholar 

  16. 16.

    Zenger M, et al. The relationship of quality of life and distress in prostate cancer patients compared to the general population. Psychosoc Med. 2010;7. https://doi.org/10.3205/psm000064.

  17. 17.

    Chamie K., et al. Prostate cancer survivorship: lessons from caring for the uninsured. In: Urologic Oncology: Seminars and Original Investigations. 2012. 30(1)102–108. https://doi.org/10.1016/j.urolonc.2011.09.001

  18. 18.

    Du K, et al. Impact of marital status and race on outcomes of patients enrolled in radiation therapy oncology group prostate cancer trials. Support Care Cancer. 2012;20(6):1317–25.

    PubMed  Google Scholar 

  19. 19.

    Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta-ethnography to synthesize qualitative research: a worked example. J Health Serv Res Policy. 2002;7(4):209–15.

    PubMed  Google Scholar 

  20. 20.

    Kane G, et al. Parenting programmes: a systematic review and synthesis of qualitative research. Child Care Health Dev. 2007;33(6):784–93.

    CAS  PubMed  Google Scholar 

  21. 21.

    Noblit GW, Hare RD. Meta-ethnography: synthesizing qualitative studies, vol. 11. Beverly Hills: Sage; 1988.

    Google Scholar 

  22. 22.

    Jones RA, Wenzel J, Hinton I, Cary M, Jones NR, Krumm S, et al. Exploring cancer support needs for older African-American men with prostate cancer. Support Care Cancer. 2011;19(9):1411–9.

    PubMed  Google Scholar 

  23. 23.

    Jones RA, Taylor AG, Bourguignon C, Steeves R, Fraser G, Lippert M, et al. Family interactions among African American prostate cancer survivors. Fam Community Health. 2008;31(3):213–20. https://doi.org/10.1097/01.FCH.0000324478.55706.fe.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Kazer MW, et al. The experiences of unpartnered men with prostate cancer: a qualitative analysis. J Cancer Surviv. 2011;5(2):132–41.

    PubMed  Google Scholar 

  25. 25.

    Maliski SL, et al. Faith among low-income, African American/black men treated for prostate cancer. Cancer Nurs. 2010;33(6):470.

    PubMed  PubMed Central  Google Scholar 

  26. 26.

    Maliski SL, Rivera S, Connor S, Lopez G, Litwin MS. Renegotiating masculine identity after prostate cancer treatment. Qual Health Res. 2008;18(12):1609–20.

    PubMed  Google Scholar 

  27. 27.

    Rivers BM, August EM, Quinn GP, Gwede CK, Pow-Sang JM, Green BL, et al. Understanding the psychosocial issues of African American couples surviving prostate cancer. J Cancer Educ. 2012;27(3):546–58.

    PubMed  PubMed Central  Google Scholar 

  28. 28.

    Rivers BM, August EM, Gwede CK, Hart A Jr, Donovan KA, Pow-Sang JM, et al. Psychosocial issues related to sexual functioning among African-American prostate cancer survivors and their spouses. Psychooncology. 2011;20(1):106–10.

    PubMed  PubMed Central  Google Scholar 

  29. 29.

    Satia JA, Walsh JF, Pruthi RSJCN. Health behavior changes in white and African American prostate cancer survivors. Cancer Nurs. 2009;32(2):107.

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Williams F, Imm KR, Colditz GA, Housten AJ, Yang L, Gilbert KL, et al. Physician role in physical activity for African-American males undergoing radical prostatectomy for prostate cancer. Support Care Cancer. 2017;25(4):1151–8.

    PubMed  Google Scholar 

  31. 31.

    Song L, Hamilton JB, Moore ADJHP. Patient-healthcare provider communication: perspectives of African American cancer patients. Health Psychol. 2012;31(5):539.

    PubMed  Google Scholar 

  32. 32.

    Clark EM, Williams BR, Huang J, Roth DL, Holt CL. A longitudinal study of religiosity, spiritual health locus of control, and health behaviors in a national sample of African Americans. J Relig Health. 2018;57(6):2258–78.

    PubMed  PubMed Central  Google Scholar 

  33. 33.

    Debnam KJ, Holt CL, Clark EM, Roth DL, Foushee HR, Crowther M, et al. Spiritual health locus of control and health behaviors in African Americans. Am J Health Behav. 2012;36(3):360–72.

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    DiIorio C, Steenland K, Goodman M, Butler S, Liff J, Roberts P. Differences in treatment-based beliefs and coping between African American and white men with prostate cancer. J Community Health. 2011;36(4):505–12.

    PubMed  Google Scholar 

  35. 35.

    Ervik B, Nordøy T, Asplund KJCN. In the middle and on the sideline: the experience of spouses of men with prostate cancer. Cancer Nurs. 2013;36(3):E7–E14.

    PubMed  Google Scholar 

  36. 36.

    Halbert CH, Barg FK, Weathers B, Delmoor E, Coyne J, Wileyto EP, et al. Differences in cultural beliefs and values among African American and European American men with prostate cancer. Cancer Control. 2007;14(3):277–84.

    Google Scholar 

  37. 37.

    Zhou ES, Penedo FJ, Lewis JE, Rasheed M, Traeger L, Lechner S, et al. Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer. J Psychosom Res. 2010;69(6):587–90.

    PubMed  PubMed Central  Google Scholar 

  38. 38.

    Brown SL, Lin IF. The gray divorce revolution: rising divorce among middle-aged and older adults, 1990–2010. J Gerontol B Psychol Sci Soc Sci. 2012;67(6):731–41.

    PubMed  PubMed Central  Google Scholar 

  39. 39.

    Kreider RM, Ellis R. Number, timing, and duration of marriages and divorces: 2009. US Department of Commerce, Economics and Statistics Administration, US Census Bureau 2011.

  40. 40.

    Brawley O. Prostate cancer epidemiology in the United States. World J Urol. 2012;30(2):195–200.

    PubMed  Google Scholar 

  41. 41.

    Teslow EA, Bao B, Dyson G, Legendre C, Mitrea C, Sakr W, et al. Exogenous IL-6 induces mRNA splice variant MBD2_v2 to promote stemness in TP53 wild-type, African American PCa cells. Mol Oncol. 2018;12(7):1138–52. https://doi.org/10.1002/1878-0261.12316.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  42. 42.

    Xin H. Racial disparity in localized prostate cancer mortality. J Natl Med Assoc. 2017;109(2):86–92. https://doi.org/10.1016/j.jnma.2017.01.007.

    Article  PubMed  Google Scholar 

  43. 43.

    Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013;31(31):3869–76.

    PubMed  PubMed Central  Google Scholar 

  44. 44.

    Kamen C, Mustian KM, Heckler C, Janelsins MC, Peppone LJ, Mohile S, et al. The association between partner support and psychological distress among prostate cancer survivors in a nationwide study. J Cancer Surviv. 2015;9(3):492–9.

    PubMed  PubMed Central  Google Scholar 

  45. 45.

    Chambers SK, Occhipinti S, Schover L, Nielsen L, Zajdlewicz L, Clutton S, et al. A randomized controlled trial of a couples-based sexuality intervention for men with localized prostate cancer and their female partners. Psychooncology. 2015;24(7):748–56.

    PubMed  Google Scholar 

  46. 46.

    Nelson CJ, Kenowitz J. Communication and intimacy-enhancing interventions for men diagnosed with prostate cancer and their partners. J Sex Med. 2013;10(1):127–32.

    PubMed  PubMed Central  Google Scholar 

  47. 47.

    Song L, Rini C, Deal A, Nielsen M, Chang H, Kinneer P, et al. Improving couples’ quality of life through a web-based prostate cancer education intervention. Oncol Nurs Forum. 2015;42(2):183–92. https://doi.org/10.1188/15.ONF.183-192.

    Article  PubMed  PubMed Central  Google Scholar 

  48. 48.

    Wittmann D, Mehta A, Northouse L, Dunn R, Braun T, Duby A, et al. TrueNTH sexual recovery study protocol: a multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial. BMC Cancer. 2017;17(1):664. https://doi.org/10.1186/s12885-017-3652-3.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Wootten A, et al. Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature. J Cancer Surviv. 2014;8(3):472–84.

    CAS  PubMed  Google Scholar 

  50. 50.

    Rivas C, et al. Ethnicity and the prostate cancer experience: a qualitative metasynthesis. Psycooncology. 2016;25(10):1147–56. https://doi.org/10.1002/pon.4222.

    Article  Google Scholar 

  51. 51.

    Reamer E, Yang F, Holmes-Rovner M, Liu J, Xu J. Influence of men’s personality and social support on treatment decision-making for localized prostate cancer. Biomed Res Int. 2017;2017:1–8. https://doi.org/10.1155/2017/1467056.

    Article  Google Scholar 

  52. 52.

    Chhatre S, Wein AJ, Malkowicz SB, Jayadevappa R. Racial differences in well-being and cancer concerns in prostate cancer patients. J Cancer Surviv. 2011;5(2):182–90.

    PubMed  Google Scholar 

  53. 53.

    Mahal BA, Ziehr DR, Aizer AA, Hyatt AS, Sammon JD, Schmid M, et al. Getting back to equal: the influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer. Urol Oncol. 2014;32(8):1285–91.

    PubMed  Google Scholar 

Download references

Funding

Lixin Song’s work was partially supported by the R01NR016990 National Institute of Nursing Research (PI: Song), R21 CA212516 National Cancer Institute (PI: Song) and University Cancer Research Fund, UNC Lineberger Comprehensive Cancer Center.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Florence Osita Okoro.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix 1. Literature search strategies

Appendix 1. Literature search strategies

Search strategy for PubMed (United States National Library of Medicine, 1809–present), September 2018

((((((“prostatic neoplasms”[Mesh]) OR prostate cancer)) AND ((“survivors”[Mesh]) OR survivor*)) AND ((“African Americans”[Mesh]) OR ((African American*) OR black american*)))) AND ((((((((((“marriage”[Mesh] OR “Spouses”[Mesh])) OR ((married) OR spous*)) OR ((partnered) OR “in a relationship”))) OR (((((“single person”[Mesh]) OR (((single) OR unmarried) OR unpartnered)) OR solitary) OR ((“divorce”[Mesh]) OR “Widowhood”[Mesh])) OR ((divorce*) OR widow*))) OR (((relationship status) OR “marital status”[Mesh]) OR marital status))) OR (((((couple*) OR dyad*) OR wife) OR wives) AND “last 10 years”[PDat])) AND “last 10 years”[PDat]) Sort by: PublicationDate

Search strategy for PsycINFO (EBSCO, seventeenth century–present), September 2018

(((DE “prostate” AND DE “neoplasms”) OR ((TI prostat* N2 cancer*) OR (AB prostat* N2 cancer*))) AND (TX localized) AND (DE “survivors” OR TX survivor*) AND ((DE “Blacks” OR (TX “African American*” OR TX black N2 American*)) AND ((TX married OR TX spouse* OR TX partner* OR TX “in a relationship” OR TX single OR TX unmarried OR TX unpartnered OR TX solitary OR TX divorce* OR TX widow* OR TX “relationship status” OR TX “marital status” OR TX “significant other*” OR TX couple* OR TX dyad* OR TX wife OR TX wives) OR (DE “spouses” OR DE “husbands” OR DE “wives” OR DE “Couples” OR DE “same sex couples” OR DE “significant others” OR DE “marital status” OR DE “never married” OR DE “divorced persons” OR DE “widowers”))

Search strategy for CINAHL Plus with full text (EBSCO, 1937–present), September 2018

(((MH “prostatic neoplasms+”) OR ((TI prostat* N2 cancer*) OR (AB prostat* N2 cancer*))) AND (TX localized) AND ((MH “survivors+”) OR (TX survivor*)) AND (((MH “Blacks”) OR ((TX “African American*”) OR (TX black N2 American*))) AND ((TX married OR TX spouse* OR TX partner* OR TX “in a relationship” OR TX single OR TX unmarried OR TX unpartnered OR TX solitary OR TX divorce* OR TX widow* OR TX “relationship status” OR TX “marital status” OR TX “significant other*” OR TX couple* OR TX dyad* OR TX wife OR TX wives) OR (MH “marital status+” OR MH “significant other” OR MH “spouses”))

Search strategy for Web of Science (Clarivate Analytics, 1900–present), September 2018

(“prostate cancer” OR “prostate neoplasm*”) AND localized AND survivor* AND (black* NEAR/2 America* OR “African American*” OR “African-American”) AND (married OR spouse* OR partner* OR “in a relationship” OR single OR unmarried OR unpartnered OR solitary OR divorce* OR widow* OR “relationship status” OR “marital status” OR “significant other*” OR couple* OR dyad* OR wife OR wives OR husband* OR couple* OR “significant other*” OR “never married”)

Search strategy for Social Services Abstracts (ProQuest, 1979–present), September 2018

(“prostate cancer” or “prostate neoplasm*”) AND localized AND survivor* AND (black* NEAR/2 America* or “African American*” or “African-American”) AND (married or spouse* or partner* or “in a relationship” or single or unmarried or unpartnered or solitary or divorce* or widow* or “relationship status” or “marital status” or “significant other*” or couple* or dyad* or wife or wives or husband* or couple* or “significant other*” or “never married”)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Okoro, F.O., Song, L., Auten, B. et al. African-American survivors of prostate cancer: a meta-synthesis of qualitative studies. J Cancer Surviv 15, 40–53 (2021). https://doi.org/10.1007/s11764-020-00909-4

Download citation

Keywords

  • African American
  • Prostate cancer
  • Cancer survivorship
  • Qualitative research
  • Coping
  • Socioeconomic
  • Supportive care
  • Meta-synthesis