Challenging sexual, urinary, and bowel symptoms are common after radical prostatectomy for prostate cancer and often persist well beyond the acute treatment and recovery period. When symptoms persist, reducing symptom distress and increasing quality of life are important symptom management goals. Symptom management efforts have traditionally focused on the patient. However, partners and the relationship are also affected when survivors experience distressing sexual, urinary, and bowel symptoms. Among African American men and their partners, the burden of symptom distress may be even greater. African American men have a 60 percent higher incidence rate of prostate cancer, more advanced disease at diagnosis, and mortality rates twice as high as those seen in Caucasian men. Research also indicates that African American men recover more slowly after treatment for prostate cancer. The proposed study seeks to evaluate the efficacy of a new, telephone-based coping skills training protocol tailored for African American prostate cancer survivors and their intimate partners. One hundred and eighty nine early stage African American prostate cancer survivors (stage T1-T3) and their intimate partners will be randomized to 1 of 3 conditions: 1) a 6-session partner-assisted Coping Skills Training (CST) intervention;2) a Cancer Education intervention of equal duration, or 3) a wait-list control condition. Survivors will complete measures of symptom-related quality of life, depression, self-efficacy, and relationship quality at 3 time-points: pre- treatment, post-treatment, and 3-months follow-up. Partners will complete measures of caregiver strain, depression, self efficacy and relationship quality at the same 3 time points. If we find that partner-assisted CST is effective in African American prostate cancer survivors who have undergone prostatectomy surgery, future studies could evaluate partner-assisted CST in African American prostate cancer survivors who have undergone radiation therapies (for example, brachytherapy). Future studies could also evaluate partner-assisted CST in other populations of African American cancer survivors where large ethnic disparities in incidence and mortality rates exist, such as lung cancer, and colon cancer. Ultimately, by rigorously evaluating an intervention to enhance coping in African American prostate cancer survivors at increased risk for being underserved, this study may enlarge our repertoire of methods for reducing symptom distress and increasing quality of life for cancer survivors who are most in need.
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