Knowledge, attitudes and beliefs of women about the importance of prostate cancer screening.

OBJECTIVES: To understand women's knowledge, attitudes and beliefs about prostate cancer. METHODS: A survey was self-administered to 324 women age >18 years. It contained 42 questions that assessed women's knowledge about prostate cancer, possible risk factors, and opinions regarding screening and early detection. Women were grouped as married or unmarried for convenient comparisons. Chi-squared and F statistics were performed. RESULTS: Ninety-seven percent of married women reported having some influence over the healthcare decisions of their spouse. Married women's worst fear about their spouse or family member's diagnosis of prostate cancer was death. The most important benefit of prostate cancer screening was the possibility of cure, while the main hindrance was fear of the digital rectal exam. Marital status, age, educational level and income were all significantly associated with women's knowledge about prostate cancer (p<0.001). CONCLUSIONS: Women play an important role in health-related matters in the home. Educating women on prostate cancer may improve early detection efforts and reduce the devastating impact of this disease on their family.

Efficacy of nilutamide as secondary hormonal therapy in androgen-independent prostate cancer.

OBJECTIVE: To evaluate the activity of nilutamide as secondary hormonal therapy in patients with androgen-independent prostate cancer (AIPC), as treatment options are limited for these patients and secondary hormonal therapy with antiandrogens has advantages, including low toxicity, oral administration and high patient acceptance. PATIENTS AND METHODS: We retrospectively identified 45 patients with AIPC who were treated with nilutamide as secondary hormonal therapy in two institutions. The decrease in prostate-specific antigen (PSA) levels, side-effects of treatment, and the relationship between baseline characteristics, type and duration of previous therapy and response to nilutamide were assessed. Most patients received oral nilutamide at 150 mg/day. RESULTS: Eighteen of 45 evaluable patients (40%) had a PSA level decrease of > or = 50%. Responders (PSA decline > or = 50%) had a median (range) time to progression of 4.4 (0.31-44.7) months. There were responses to nilutamide whether used as the second to fifth line of hormonal therapy. There were no differences in response to nilutamide based on clinical stage, type of local therapy, PSA level at diagnosis or initiation of nilutamide, or type of previous antiandrogen therapy. Responders were more likely to have received monotherapy with luteinizing hormone-releasing hormone analogues or orchidectomy as first-line hormonal treatment (P = 0.02). The most common reversible adverse effects were mild to moderate visual adaptation effects, reported in 20% of patients. CONCLUSIONS: Nilutamide appears to be an effective secondary hormonal therapy in patients with AIPC and is associated with a mild toxicity profile.

Statewide analysis of serum prostate specific antigen levels in Louisiana men without prostate cancer.

OBJECTIVES: To examine age, racial, and regional differences in serum PSA levels among men in Louisiana. METHODS: From January 1, 2001 through December 31, 2001, there were 10,012 serum PSA tests performed at Louisiana Health Care Services Division (HCSD) hospitals. Manual and electronic data mining were performed to select the earliest PSA value in those men who had multiple determinations. This PSA data file was then linked with those of the Louisiana Tumor Registry and from HCSD pathology laboratories, all matched cases were removed. Men younger than 40 years and older than 79 years were excluded from this study. The final data file contained 7,258 men, of whom 4,244 were African-Americans and 3,014 were Caucasians. Comparisons of median and geometric mean serum PSA level were made between and among races for each age-decade as well as among the hospitals to assess for racial and regional differences. RESULTS: Median PSA levels were statistically significantly higher in African-American men than in Caucasian men for each age group (p < or = 0.0002). The median PSA (ng/ml) for African-American men was 0.7, 0.9, 1.3, and 2.3 for age-decades 40-49, 50-59, 60-69, and 70-79, respectively, whereas for Caucasian men the median PSA levels were 0.8, 1.2, and 1.6 for age-decades 50-59, 60-69, and 70-79, respectively. Nonparametric analysis of variance did not demonstrate a regional pattern of PSA values among the hospitals. CONCLUSIONS: In a first statewide analysis of age and racial differences of serum PSA levels, African-American men without prostate cancer had significantly higher serum PSA levels than their age-matched Caucasian male counterparts. Additionally, there were no regional patterns of PSA values among the racial groups.