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Age, Health, and Education Determine Supportive Care Needs of Men Younger Than 70 Years With Prostate Cancer

David P. Smith, Rajah Supramaniam, Madeleine T. King, Jeanette Ward, Martin Berry, Bruce K. Armstrong

From the Cancer Epidemiology Research Unit, Cancer Council New South Wales; Centre for Health Economics, Research & Evaluation; Cancer Therapy Centre, Liverpool Health Service; Sydney Cancer Centre and School of Public Health, University of Sydney, Sydney, Australia; and the Institute of Population Health, Ottawa, Canada

Address reprint requests to David P. Smith, Cancer Epidemiology Research Unit, Cancer Council New South Wales, PO Box 572, Woolloomooloo, New South Wales 1340, Australia; e-mail: dsmith{at}nswcc.org.au

Purpose It is important to meet the supportive care needs of cancer patients to ensure their satisfaction with their care. A population-wide sample of men younger than 70 years and newly diagnosed with prostate cancer was surveyed to determine their unmet needs in five domains and the factors predicting them.

Patients and Methods Eligible men were younger than 70 years and residents in New South Wales, Australia, with newly diagnosed histopathologically confirmed prostate cancer. Sixty-seven percent of eligible men diagnosed between October 2000 and October 2001 participated. Demographic, treatment, and self-reported health data were collected. Information on cancer stage, grade, and prostate-specific antigen was obtained from medical records. Logistic regression analyses determined patient and treatment variables that predicted higher unmet needs.

Results More than half (54%) of men with prostate cancer expressed some level of unmet psychological need, and 47% expressed unmet sexuality needs. Nearly one fourth expressed a moderate or high level of unmet need with respect to changes in sexuality. Sexuality needs were independently predicted by being younger, having had a secondary school education only, having had surgery, and being married, living as married, or divorced. Uncertainty about the future was also an important area of unmet need.

Conclusion Attention should be given to sexual and psychological needs in the early months after diagnosis or treatment of prostate cancer, particularly in younger men, those with less education, and those having surgery. Research into better ways of meeting these needs will enable us to meet them with as much rigor as we meet clinical treatment needs.

Supported by a grant from the Australian Department of Veterans Affairs. B.A. was supported by a grant from the University of Sydney Medical Foundation Program.

Presented in part in poster format at the XVII International Epidemiology Association World Congress of Epidemiology, August 21-25, 2005, Bangkok, Thailand.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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