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Loeb S, Hua Q, Bauer SR, Kenfield SA, Morgans AK, Chan JM, Van Blarigan EL, Shreves AH, Mucci LA. Plant-based diet associated with better quality of life in prostate cancer survivors. Cancer 2024; 130:1618-1628. [PMID: 38348508 PMCID: PMC11009061 DOI: 10.1002/cncr.35172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Plant-based diets have many health benefits, including a lower risk of fatal prostate cancer, and greater environmental sustainability. However, less is known regarding the impact of plant-based diets on quality of life among individuals diagnosed with prostate cancer. The authors' objective was to examine the relationship between plant-based diet indices postdiagnosis with quality of life. METHODS This prospective cohort study included 3505 participants in the Health Professionals Follow-Up Study (1986-2016) with nonmetastatic prostate cancer. Food-frequency questionnaires were used to calculate overall and healthful plant-based diet indices. Quality-of-life scores were calculated using the Expanded Prostate Cancer Index Composite. Generalized estimating equations were used to examine associations over time between plant-based diet indices and quality-of-life domains (sexual functioning, urinary irritation/obstruction, urinary incontinence, bowel functioning, hormonal/vitality), adjusted for demographics, oncologic history, body mass index, caloric intake, health-related behaviors, and comorbidities. RESULTS The median age at prostate cancer diagnosis was 68 years; 48% of patients underwent radical prostatectomy, and 35% received radiation as primary therapy. The median time from diagnosis/treatment to first the quality-of-life questionnaire was 7.0 years. A higher plant-based diet index was associated with better scores for sexual function, urinary irritation/obstruction, urinary incontinence, and hormonal/vitality. Consuming more healthful plant-based foods was also associated with better sexual and bowel function, as well as urinary incontinence and hormonal/vitality scores in the age-adjusted analysis, but not in the multivariable analysis. CONCLUSIONS This prospective study provides supportive evidence that greater consumption of healthful plant-based foods is associated with modestly higher scores in quality-of-life domains among patients with prostate cancer.
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Affiliation(s)
- Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, New York, USA
| | - Qi Hua
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Scott R Bauer
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Stacey A Kenfield
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Alicia K Morgans
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - June M Chan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Alaina H Shreves
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- American Cancer Society, Atlanta, Georgia, USA
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James ND, Tannock I, N'Dow J, Feng F, Gillessen S, Ali SA, Trujillo B, Al-Lazikani B, Attard G, Bray F, Compérat E, Eeles R, Fatiregun O, Grist E, Halabi S, Haran Á, Herchenhorn D, Hofman MS, Jalloh M, Loeb S, MacNair A, Mahal B, Mendes L, Moghul M, Moore C, Morgans A, Morris M, Murphy D, Murthy V, Nguyen PL, Padhani A, Parker C, Rush H, Sculpher M, Soule H, Sydes MR, Tilki D, Tunariu N, Villanti P, Xie LP. The Lancet Commission on prostate cancer: planning for the surge in cases. Lancet 2024; 403:1683-1722. [PMID: 38583453 DOI: 10.1016/s0140-6736(24)00651-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/28/2023] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Nicholas D James
- Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
| | - Ian Tannock
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Felix Feng
- University of California, San Francisco, USA
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Syed Adnan Ali
- University of Manchester, Manchester, UK; The Christie Hospital, Manchester, UK
| | | | | | | | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
| | - Eva Compérat
- Tenon Hospital, Sorbonne University, Paris; AKH Medical University, Vienna, Austria
| | - Ros Eeles
- Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | - Áine Haran
- The Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | | | | | | | - Stacy Loeb
- New York University, New York, NY, USA; Manhattan Veterans Affairs, New York, NY, USA
| | | | | | | | - Masood Moghul
- Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | | | - Michael Morris
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Declan Murphy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | | | | | | | | | | | - Howard Soule
- Prostate Cancer Foundation, Santa Monica, CA, USA
| | | | - Derya Tilki
- Martini-Klinik Prostate Cancer Center and Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Türkiye
| | - Nina Tunariu
- Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Li-Ping Xie
- First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Qian Z, Beatrici E, Trinh QD, Kibel AS, Loeb S, Iyer HS, Cole AP. Climate change perception and its association with cancer screening intent. J Natl Cancer Inst 2024; 116:618-622. [PMID: 38086539 DOI: 10.1093/jnci/djad237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 04/06/2024] Open
Abstract
As the climate crisis deepens, its adverse effects on human health are becoming evident, including impacts on cancer pathogenesis and treatment. This study explored the link between individuals' awareness of the health impacts of climate change and interest in cancer screening. Using the 2021 Health Information National Trends Survey, our study demonstrated a statistically significant association between recognition of climate change as a personal health threat and interest in cancer screening. Although the study's retrospective nature and self-reported data pose some limitations, these findings signal a promising avenue for future research on the intersection of climate and cancer risk. This research supports the development of public health interventions that incorporate components of environmental health literacy alongside cancer screening efforts.
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Affiliation(s)
- Zhiyu Qian
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Edoardo Beatrici
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Urology, Humanitas Research Hospital, Milan, Italy
| | - Quoc-Dien Trinh
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Adam S Kibel
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA
| | - Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Alexander P Cole
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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4
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Englman C, Maffei D, Allen C, Kirkham A, Albertsen P, Kasivisvanathan V, Baroni RH, Briganti A, De Visschere P, Dickinson L, Gómez Rivas J, Haider MA, Kesch C, Loeb S, Macura KJ, Margolis D, Mitra AM, Padhani AR, Panebianco V, Pinto PA, Ploussard G, Puech P, Purysko AS, Radtke JP, Rannikko A, Rastinehad A, Renard-Penna R, Sanguedolce F, Schimmöller L, Schoots IG, Shariat SF, Schieda N, Tempany CM, Turkbey B, Valerio M, Villers A, Walz J, Barrett T, Giganti F, Moore CM. PRECISE Version 2: Updated Recommendations for Reporting Prostate Magnetic Resonance Imaging in Patients on Active Surveillance for Prostate Cancer. Eur Urol 2024:S0302-2838(24)02232-2. [PMID: 38556436 DOI: 10.1016/j.eururo.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/21/2024] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND OBJECTIVE The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations standardise the reporting of prostate magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer. An international consensus group recently updated these recommendations and identified the areas of uncertainty. METHODS A panel of 38 experts used the formal RAND/UCLA Appropriateness Method consensus methodology. Panellists scored 193 statements using a 1-9 agreement scale, where 9 means full agreement. A summary of agreement, uncertainty, or disagreement (derived from the group median score) and consensus (determined using the Interpercentile Range Adjusted for Symmetry method) was calculated for each statement and presented for discussion before individual rescoring. KEY FINDINGS AND LIMITATIONS Participants agreed that MRI scans must meet a minimum image quality standard (median 9) or be given a score of 'X' for insufficient quality. The current scan should be compared with both baseline and previous scans (median 9), with the PRECISE score being the maximum from any lesion (median 8). PRECISE 3 (stable MRI) was subdivided into 3-V (visible) and 3-NonV (nonvisible) disease (median 9). Prostate Imaging Reporting and Data System/Likert ≥3 lesions should be measured on T2-weighted imaging, using other sequences to aid in the identification (median 8), and whenever possible, reported pictorially (diagrams, screenshots, or contours; median 9). There was no consensus on how to measure tumour size. More research is needed to determine a significant size increase (median 9). PRECISE 5 was clarified as progression to stage ≥T3a (median 9). CONCLUSIONS AND CLINICAL IMPLICATIONS The updated PRECISE recommendations reflect expert consensus opinion on minimal standards and reporting criteria for prostate MRI in AS. PATIENT SUMMARY The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations are used in clinical practice and research to guide the interpretation and reporting of magnetic resonance imaging for patients on active surveillance for prostate cancer. An international panel has updated these recommendations, clarified the areas of uncertainty, and highlighted the areas for further research.
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Affiliation(s)
- Cameron Englman
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Davide Maffei
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Clare Allen
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Alex Kirkham
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Peter Albertsen
- Department of Surgery (Urology), UConn Health, Farmington, CT, USA
| | - Veeru Kasivisvanathan
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Ronaldo Hueb Baroni
- Department of Radiology, Hospital Israelita Albert Einstein. Sao Paulo, Brazil
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Pieter De Visschere
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Louise Dickinson
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Juan Gómez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Masoom A Haider
- Joint Department of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Canada
| | - Claudia Kesch
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Stacy Loeb
- Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA
| | - Katarzyna J Macura
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel Margolis
- Weill Cornell Medical College, Department of Radiology, New York, NY, USA
| | - Anita M Mitra
- Department of Cancer Services, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Middlesex, UK
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Philippe Puech
- Department of Radiology, University of Lille, Lille, France
| | - Andrei S Purysko
- Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jan Philipp Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf, Germany
| | - Antti Rannikko
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Art Rastinehad
- Department of Urology, Lenox Hill Hospital, New York, NY, USA
| | - Raphaele Renard-Penna
- Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Francesco Sanguedolce
- Department of Urology, Autonoma University of Barcelona, Barcelona, Spain; Department of Medicine, Surgery and Pharmacy, Universitá degli studi di Sassari - Italy
| | - Lars Schimmöller
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany
| | - Ivo G Schoots
- Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan
| | - Nicola Schieda
- Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - Clare M Tempany
- Department of Radiology Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Massimo Valerio
- Department of Urology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Arnauld Villers
- Department of Urology, Hospital Claude Huriez, CHU Lille, Lille, France
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Center, Marseille, France
| | - Tristan Barrett
- Department of Radiology, University of Cambridge, Addenbrook''s Hospital, Cambridge, UK
| | - Francesco Giganti
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
| | - Caroline M Moore
- Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
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5
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Loeb S, Sanchez Nolasco T, Byrne N, Allen L, Langford AT, Ravenell J, Gomez SL, Washington SL, Borno HT, Griffith DM, Criner N. Representation Matters: Trust in Digital Health Information Among Black Patients With Prostate Cancer. J Urol 2024; 211:376-383. [PMID: 38329047 DOI: 10.1097/ju.0000000000003822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/08/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE Although the majority of US adults obtain health information on the internet, the quality of information about prostate cancer is highly variable. Black adults are underrepresented in online content about prostate cancer despite a higher incidence of and mortality from the disease. The goal of this study was to explore the perspectives of Black patients with prostate cancer on the importance of racial representation in online content and other factors influencing trust. MATERIALS AND METHODS We conducted 7 virtual focus groups with Black patients with prostate cancer in 2022 and 2023. Participants completed an intake questionnaire with demographics followed by a group discussion, including feedback on purposefully selected online content. Transcripts were independently analyzed by 2 investigators experienced in qualitative research using a constant comparative method. RESULTS Most participants use online sources to look for prostate cancer information. Racial representation is an important factor affecting trust in the content. A lack of Black representation has consequences, including misperceptions about a lower risk of prostate cancer and discouraging further information-seeking. Other key themes affecting trust in online content included the importance of a reputable source of information, professional website structure, and soliciting money. CONCLUSIONS Underrepresentation of Black adults in prostate cancer content has the potential to worsen health disparities. Optimal online communications should include racially diverse representation and evidence-based information in a professional format from reputable sources without financial conflict.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, New York
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Nataliya Byrne
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Laura Allen
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Aisha T Langford
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan
| | - Joseph Ravenell
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Scarlett Lin Gomez
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Samuel L Washington
- Department of Urology, University of California San Francisco, San Francisco, California
| | - Hala T Borno
- Department of Medical Oncology, University of California San Francisco, San Francisco, California
- Trial Library Inc, San Francisco, California
| | - Derek M Griffith
- Department of Health Management and Policy, Racial Justice Institute and Center for Men's Health Equity, Georgetown University, Washington, Disctrict of Columbia
| | - Nickole Criner
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
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Scott C, Campbell P, Nemirovsky A, Loeb S, Malik R. Prostate cancer and podcasts: an analysis and assessment of the quality of information about prostate cancer available on podcasts. Prostate Cancer Prostatic Dis 2024; 27:153-154. [PMID: 37491431 DOI: 10.1038/s41391-023-00694-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/29/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
Podcasts represent a new source of information for patients and families dealing with prostate cancer, but no studies have been conducted evaluating the quality of information in them. Evaluating for: (1) quality based on the validated DISCERN criteria, (2) understandability and actionability based on the Patient Education Materials Assessment Tool (PEMAT), (3) misinformation, and (4) commercial bias, we concluded that podcasts are currently not good sources of information for lay health consumers.
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Affiliation(s)
- Colin Scott
- University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Peter Campbell
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amy Nemirovsky
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Stacy Loeb
- New York University Langone Medical Center, New York, NY, USA
| | - Rena Malik
- University of Maryland Medical Center, Baltimore, MD, USA
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7
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Loeb S, Keith SW, Cheng HH, Leader AE, Gross L, Sanchez Nolasco T, Byrne N, Hartman R, Brown LH, Pieczonka CM, Gomella LG, Kelly WK, Lallas CD, Handley N, Mille PJ, Mark JR, Brown GA, Chopra S, McClellan A, Wise DR, Hollifield L, Giri VN. TARGET: A Randomized, Noninferiority Trial of a Pretest, Patient-Driven Genetic Education Webtool Versus Genetic Counseling for Prostate Cancer Germline Testing. JCO Precis Oncol 2024; 8:e2300552. [PMID: 38452310 PMCID: PMC10939575 DOI: 10.1200/po.23.00552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Germline genetic testing (GT) is important for prostate cancer (PCA) management, clinical trial eligibility, and hereditary cancer risk. However, GT is underutilized and there is a shortage of genetic counselors. To address these gaps, a patient-driven, pretest genetic education webtool was designed and studied compared with traditional genetic counseling (GC) to inform strategies for expanding access to genetic services. METHODS Technology-enhanced acceleration of germline evaluation for therapy (TARGET) was a multicenter, noninferiority, randomized trial (ClinicalTrials.gov identifier: NCT04447703) comparing a nine-module patient-driven genetic education webtool versus pretest GC. Participants completed surveys measuring decisional conflict, satisfaction, and attitudes toward GT at baseline, after pretest education/counseling, and after GT result disclosure. The primary end point was noninferiority in reducing decisional conflict between webtool and GC using the validated Decisional Conflict Scale. Mixed-effects regression modeling was used to compare decisional conflict between groups. Participants opting for GT received a 51-gene panel, with results delivered to participants and their providers. RESULTS The analytic data set includes primary outcome data from 315 participants (GC [n = 162] and webtool [n = 153]). Mean difference in decisional conflict score changes between groups was -0.04 (one-sided 95% CI, -∞ to 2.54; P = .01), suggesting the patient-driven webtool was noninferior to GC. Overall, 145 (89.5%) GC and 120 (78.4%) in the webtool arm underwent GT, with pathogenic variants in 15.8% (8.7% in PCA genes). Satisfaction did not differ significantly between arms; knowledge of cancer genetics was higher but attitudes toward GT were less favorable in the webtool arm. CONCLUSION The results of the TARGET study support the use of patient-driven digital webtools for expanding access to pretest genetic education for PCA GT. Further studies to optimize patient experience and evaluate them in diverse patient populations are warranted.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, NYU Langone Health, New York, NY
- Department of Population Health, NYU Langone Health, New York, NY
- Perlmutter Cancer Center, NYU Langone Health, New York, NY
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, NY
| | - Scott W. Keith
- Division of Biostatistics and Bioinformatics, Department of Pharmacology, Physiology and Cancer Biology, Thomas Jefferson University, Philadelphia, PA
| | - Heather H. Cheng
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Center, Seattle, WA
| | - Amy E. Leader
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Laura Gross
- Yale Cancer Center, New Haven, CT
- Yale New Haven Health, New Haven, CT
| | - Tatiana Sanchez Nolasco
- Department of Urology, NYU Langone Health, New York, NY
- Department of Population Health, NYU Langone Health, New York, NY
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, NY
| | - Nataliya Byrne
- Department of Urology, NYU Langone Health, New York, NY
- Department of Population Health, NYU Langone Health, New York, NY
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, NY
| | - Rebecca Hartman
- Division of Biostatistics and Bioinformatics, Department of Pharmacology, Physiology and Cancer Biology, Thomas Jefferson University, Philadelphia, PA
| | | | | | - Leonard G. Gomella
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - William Kevin Kelly
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Costas D. Lallas
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Nathan Handley
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA
| | | | - James Ryan Mark
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | | | | | - David R. Wise
- Perlmutter Cancer Center, NYU Langone Health, New York, NY
| | | | - Veda N. Giri
- Yale Cancer Center, New Haven, CT
- Department of Medicine, Yale School of Medicine, New Haven, CT
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8
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Loeb S, Sanchez Nolasco T, Byrne N, Allen L, Langford AT, Ravenell JE, Gomez SL, Washington SL, Borno HT, Griffith DM, Criner N. Qualitative Study on Internet Use and Care Impact for Black Men With Prostate Cancer. Health Educ Behav 2024:10901981241228226. [PMID: 38366884 DOI: 10.1177/10901981241228226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.
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Affiliation(s)
- Stacy Loeb
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | | | | | - Laura Allen
- University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Hala T Borno
- University of California San Francisco, San Francisco, CA, USA
- Trial Library Inc., San Francisco, CA, USA
| | - Derek M Griffith
- Department of Health Management and Policy, Racial Justice Institute and Center for Men's Health Equity, Georgetown University, Washington, DC, USA
| | - Nickole Criner
- University of California San Francisco, San Francisco, CA, USA
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9
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Gupta N, Zebib L, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Schofield E, Loeb S. Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer. Urology 2024; 184:19-25. [PMID: 38160766 DOI: 10.1016/j.urology.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners. METHODS We conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semistructured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners. RESULTS Overall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists. CONCLUSIONS To our knowledge, this is the largest study to date on female partners' unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.
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Affiliation(s)
- Natasha Gupta
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY.
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nataliya Byrne
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Tatiana Sanchez Nolasco
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Elizabeth Schofield
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
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10
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Pattenden TA, Thangasamy IA, Ong WL, Samaranayke D, Morton A, Murphy DG, Evans S, Millar J, Chalasani V, Rashid P, Winter M, Vela I, Pryor D, Mark S, Loeb S, Lawrentschuk N, Pritchard E. Barriers and enablers of active surveillance for prostate cancer: a qualitive study of clinicians. BJU Int 2024; 133 Suppl 3:48-56. [PMID: 37696615 DOI: 10.1111/bju.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVES To identify and explore barriers to, and enablers of, active surveillance (AS) in men with low-risk prostate cancer (LRPCa), as perceived by PCa clinicians. PATIENTS AND METHODS Urologists and radiation oncologists in Australia and New Zealand were purposively sampled for a cross-section on gender and practice setting (metropolitan/regional; public/private). Using a grounded theory approach, semi-structed interviews were conducted with participants. Interviews were coded independently by two researchers using open, axial, and selective coding. A constant comparative approach was used to analyse data as it was collected. Thematic saturation was reached after 18 interviews, and a detailed model of barriers to, and enablers of, AS for LRPCa, as perceived by clinicians was developed. RESULTS A model explaining what affects clinician decision making regarding AS in LRPCa emerged. It was underpinned by three broad themes: (i) clinician perception of patients' barriers and enablers; (ii) clinician perception of their own barriers and enablers; and (iii) engagement with healthcare team and resource availability. CONCLUSIONS Clinicians unanimously agree that AS is an evidence-based approach for managing LRPCa. Despite this many men do not undergo AS for LRPCa, which is due to the interplay of patient and clinician factors, and their interaction with the wider healthcare system. This study identifies strategies to mitigate barriers and enhance enablers, which could increase access to AS by patients with LRPCa.
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Affiliation(s)
- Trent A Pattenden
- Department of Urology, Ipswich Hospital, Ipswich, Queensland, Australia
| | - Isaac A Thangasamy
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, Australia
- School of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Wee Loon Ong
- Alfred Health Radiation Oncology, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Dhanika Samaranayke
- Department of Urology, Ipswich Hospital, Ipswich, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Morton
- Department of Urology, Ipswich Hospital, Ipswich, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jeremy Millar
- Alfred Health Radiation Oncology, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Venu Chalasani
- School of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Prem Rashid
- Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Matthew Winter
- Nepean Urology Research Group, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Ian Vela
- Australian Prostate Cancer Research Centre - Queensland, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Urology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - David Pryor
- Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Stephen Mark
- Department of Urology, Christchurch Hospital, Christchurch, New Zealand
| | - Stacy Loeb
- New York University, New York City, NY, USA
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- EJ Whitten Prostate Cancer Research Centre, Epworth, Melbourne, Victoria, Australia
| | - Elizabeth Pritchard
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Pan A, Musheyev D, Loeb S, Kabarriti AE. Quality of erectile dysfunction information from ChatGPT and other artificial intelligence chatbots. BJU Int 2024; 133:152-154. [PMID: 37997563 DOI: 10.1111/bju.16209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Affiliation(s)
- Alexander Pan
- Department of Urology, State University of New York Downstate Health Sciences University, New York City, NY, USA
| | - David Musheyev
- Department of Urology, State University of New York Downstate Health Sciences University, New York City, NY, USA
| | - Stacy Loeb
- Department of Urology, New York University and Manhattan Veterans Affairs, New York City, NY, USA
- Department of Population Health, New York University, New York City, NY, USA
| | - Abdo E Kabarriti
- Department of Urology, State University of New York Downstate Health Sciences University, New York City, NY, USA
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12
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Becker DJ, Csehak K, Barbaro AM, Roman SD, Loeb S, Makarov DV, Sherman S, Lim S. Experiences of oncology researchers in the Veterans Health Administration during the COVID-19 pandemic. PLoS One 2024; 19:e0290785. [PMID: 38266017 PMCID: PMC10807772 DOI: 10.1371/journal.pone.0290785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/15/2023] [Indexed: 01/26/2024] Open
Abstract
The Veterans Health Administration is chartered "to serve as the primary backup for any health care services needed…in the event of war or national emergency" according to a 1982 Congressional Act. This mission was invoked during the COVID-19 pandemic to divert clinical and research resources. We used an electronic mixed-methods questionnaire constructed using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation (COM-B) model for behavior change to study the effects of the pandemic on VHA researchers. The questionnaire was distributed electronically to 118 cancer researchers participating in national VHA collaborations. The questionnaire received 42 responses (36%). Only 36% did not feel that their research focus changed during the pandemic. Only 26% reported prior experience with infectious disease research, and 74% agreed that they gained new research skills. When asked to describe helpful support structures, 29% mentioned local supervisors, mentors, and research staff, 15% cited larger VHA organizations and 18% mentioned remote work. Lack of timely communication and remote work, particularly for individuals with caregiving responsibilities, were limiting factors. Fewer than half felt professionally rewarded for pursuing research related to COVID. This study demonstrated the tremendous effects of the COVID-19 pandemic on research activities of VHA investigators. We identified perceptions of insufficient recognition and lack of professional advancement related to pandemic-era research, yet most reported gaining new research skills. Individualizing the structure of remote work and ensuring clear and timely team communication represent high yield areas for improvement.
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Affiliation(s)
- Daniel J. Becker
- Department of Hematology and Medical Oncology, Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York, United States of America
- Department of Hematology and Medical Oncology, VA New York Harbor Healthcare System, Manhattan Campus, New York, New York, United States of America
| | - Kenneth Csehak
- Department of Hematology and Medical Oncology, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Alexander M. Barbaro
- Department of Hematology and Medical Oncology, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Stefanie D. Roman
- Department of Hematology and Medical Oncology, VA New York Harbor Healthcare System, Manhattan Campus, New York, New York, United States of America
| | - Stacy Loeb
- Department of Urology, NYU Grossman School of Medicine, New York, New York, United States of America
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Danil V. Makarov
- Department of Urology, NYU Grossman School of Medicine, New York, New York, United States of America
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Scott Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Sahnah Lim
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
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13
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Loeb S, Cheng HH, Paller CJ, Weg E, Johnson J, Gross L, Keith SW, Russo J, Hathaway F, Rivera A, Giri VN. Addressing gaps in healthcare provider knowledge regarding germline testing for prostate cancer through development and testing of a virtual genetics board. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-023-00778-9. [PMID: 38172199 DOI: 10.1038/s41391-023-00778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/10/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Germline testing is important in prostate cancer and evaluation can be complex. METHODS We instituted a monthly multi-disciplinary virtual genetics tumor board (7/2021-3/2022). Participants and panelists were surveyed on usefulness and acceptability. RESULTS 101 participants attended a session, and 77 follow-up surveys were completed. Over 90% participants and 100% panelists endorsed usefulness of the case discussions and usability of the technology. The majority felt it provided new information they will use. CONCLUSIONS A multidisciplinary genetics board was successfully developed to address complexity in prostate cancer genetics. The virtual platform may enhance dissemination of expertise where there are regional gaps.
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Affiliation(s)
- Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA.
| | - Heather H Cheng
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Channing J Paller
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MA, USA
| | - Emily Weg
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Jennifer Johnson
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Laura Gross
- Yale School of Medicine and Yale Cancer Center, New Haven, CT, USA
| | - Scott W Keith
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Medical Colllege, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jessica Russo
- MD Anderson Cancer Center at Cooper University Health Care, Camden, NJ, USA
| | - Feighanne Hathaway
- Hematology/Oncology, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Adrian Rivera
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Veda N Giri
- Yale School of Medicine and Yale Cancer Center, New Haven, CT, USA
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14
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Pekala KR, Shill DK, Austria M, Langford AT, Loeb S, Carlsson SV. Shared decision-making before prostate cancer screening decisions. Nat Rev Urol 2024:10.1038/s41585-023-00840-0. [PMID: 38168921 DOI: 10.1038/s41585-023-00840-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/05/2024]
Abstract
Decisions around prostate-specific antigen screening require a patient-centred approach, considering the benefits and risks of potential harm. Using shared decision-making (SDM) can improve men's knowledge and reduce decisional conflict. SDM is supported by evidence, but can be difficult to implement in clinical settings. An inclusive definition of SDM was used in order to determine the prevalence of SDM in prostate cancer screening decisions. Despite consensus among guidelines endorsing SDM practice, the prevalence of SDM occurring before the decision to undergo or forgo prostate-specific antigen testing varied between 11% and 98%, and was higher in studies in which SDM was self-reported by physicians than in patient-reported recollections and observed practices. The influence of trust and continuity in physician-patient relationships were identified as facilitators of SDM, whereas common barriers included limited appointment times and poor health literacy. Decision aids, which can help physicians to convey health information within a limited time frame and give patients increased autonomy over decisions, are underused and were not shown to clearly influence whether SDM occurs. Future studies should focus on methods to facilitate the use of SDM in clinical settings.
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Affiliation(s)
- Kelly R Pekala
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mia Austria
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Aisha T Langford
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Stacy Loeb
- Department of Population Health, New York University, New York, NY, USA
- Department of Urology, New York University and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Sigrid V Carlsson
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Department of Translational Medicine, Division of Urological Cancers, Medical Faculty, Lund University, Lund, Sweden.
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15
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Leapman MS, Sutherland R, Gross CP, Ma X, Seibert TM, Cooperberg MR, Catalona WJ, Loeb S, Schulman‐Green D. Patient experiences with tissue-based genomic testing during active surveillance for prostate cancer. BJUI Compass 2024; 5:142-149. [PMID: 38179031 PMCID: PMC10764160 DOI: 10.1002/bco2.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 01/06/2024] Open
Abstract
Background Tissue-based gene expression (genomic) tests provide estimates of prostate cancer aggressiveness and are increasingly used for patients considering or engaged in active surveillance. However, little is known about patient experiences with genomic testing and its role in their decision-making. Methods We performed a qualitative study consisting of in-depth, semi-structured interviews of patients with low- or favourable-intermediate-risk prostate cancer managed with active surveillance. We purposively sampled to include patients who received biopsy-based genomic testing as part of clinical care. The interview guide focused on experiences with genomic testing during patients' decision-making for prostate cancer management and understanding of genomic test results. We continued interviews until thematic saturation was reached, iteratively created a code key and used conventional content analysis to analyse data. Results Participants' (n = 20) mean age was 68 years (range 51-79). At initial biopsy, 17 (85%) had a Gleason grade group 1, and 3 (15%) had a grade group 2 prostate cancer. The decision to undergo genomic testing was driven by both participants and physicians' recommendations; however, some participants were unaware that testing had occurred. Overall, participants understood the role of genomic testing in estimating their prostate cancer risk, and the test results increased their confidence in the decision for active surveillance. Participants had some misconceptions about the difference between tissue-based gene expression tests and germline genetic tests and commonly believed that tissue-based tests measured hereditary cancer risk. While some participants expressed satisfaction with their physicians' explanations, others felt that communication was limited and lacked sufficient detail. Conclusion Patients interact with and are influenced by the results of biopsy-based genomic testing during active surveillance for prostate cancer, despite gaps in understanding about test results. Our findings indicate areas for improvement in patient counselling in order to increase patient knowledge and comfort with genomic testing.
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Affiliation(s)
- Michael S. Leapman
- Department of UrologyYale School of MedicineNew HavenConnecticutUSA
- Yale Cancer OutcomesPublic Policy, and Effectiveness Research CenterNew HavenConnecticutUSA
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | | | - Cary P. Gross
- Yale Cancer OutcomesPublic Policy, and Effectiveness Research CenterNew HavenConnecticutUSA
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Xiaomei Ma
- Yale Cancer OutcomesPublic Policy, and Effectiveness Research CenterNew HavenConnecticutUSA
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | - Tyler M. Seibert
- Department of Radiation Medicine and Applied SciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of RadiologyUniversity of California San DiegoLa JollaCaliforniaUSA
- Department of BioengineeringUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Matthew R. Cooperberg
- Department of UrologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - William J. Catalona
- Department of UrologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Stacy Loeb
- Departments of Urology and Population HealthNew York University Langone HealthNew YorkNew YorkUSA
- Manhattan Veterans Affairs Medical CenterNew YorkNew YorkUSA
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16
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Musheyev D, Pan A, Loeb S, Kabarriti AE. How Well Do Artificial Intelligence Chatbots Respond to the Top Search Queries About Urological Malignancies? Eur Urol 2024; 85:13-16. [PMID: 37567827 DOI: 10.1016/j.eururo.2023.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/18/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023]
Abstract
Artificial intelligence (AI) chatbots are becoming a popular source of information but there are limited data on the quality of information on urological malignancies that they provide. Our objective was to characterize the quality of information and detect misinformation about prostate, bladder, kidney, and testicular cancers from four AI chatbots: ChatGPT, Perplexity, Chat Sonic, and Microsoft Bing AI. We used the top five search queries related to prostate, bladder, kidney, and testicular cancers according to Google Trends from January 2021 to January 2023 and input them into the AI chatbots. Responses were evaluated for quality, understandability, actionability, misinformation, and readability using published instruments. AI chatbot responses had moderate to high information quality (median DISCERN score 4 out of 5, range 2-5) and lacked misinformation. Understandability was moderate (median Patient Education Material Assessment Tool for Printable Materials [PEMAT-P] understandability 66.7%, range 44.4-90.9%) and actionability was moderate to poor (median PEMAT-P actionability 40%, range 0-40%The responses were written at a fairly difficult reading level. AI chatbots produce information that is generally accurate and of moderate to high quality in response to the top urological malignancy-related search queries, but the responses lack clear, actionable instructions and exceed the reading level recommended for consumer health information. PATIENT SUMMARY: Artificial intelligence chatbots produce information that is generally accurate and of moderately high quality in response to popular Google searches about urological cancers. However, their responses are fairly difficult to read, are moderately hard to understand, and lack clear instructions for users to act on.
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Affiliation(s)
- David Musheyev
- Department of Urology, State University of New York Downstate Health Sciences University, New York, NY, USA
| | - Alexander Pan
- Department of Urology, State University of New York Downstate Health Sciences University, New York, NY, USA
| | - Stacy Loeb
- Department of Urology, New York University and Manhattan Veterans Affairs, New York, NY, USA; Department of Population Health, New York University, New York, NY, USA
| | - Abdo E Kabarriti
- Department of Urology, State University of New York Downstate Health Sciences University, New York, NY, USA.
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17
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Wang EY, Armas-Phan M, Meng MV, Loeb S, Kenfield SA, Porten SP. Wake-Up Call to Address Sleep Health in Non-Muscle Invasive Bladder Cancer: Underappreciated Contributor to Poor Quality of Life. Bladder Cancer 2023; 9:323-326. [PMID: 38174125 PMCID: PMC10759800 DOI: 10.3233/blc-230061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/12/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Few studies have specifically examined sleep health in patients with non-muscle invasive bladder cancer (NMIBC). Further study is warranted to inform future strategies in patients with NMIBC. OBJECTIVE We aim to describe sleep health in a cohort of patients with NMIBC, and its relationship with quality of life (QOL). METHODS We conducted an observational cross-sectional study in patients undergoing surveillance for NMIBC. The validated Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep health (scores from 0-21) in the overall study population as well as stratified. We assessed QOL among participants with and without poor sleep quality using the SF-12 and QLQ-NMIBC-24. RESULTS In a cohort of 94 NMIBC patients, median age was 67 years (IQR: 58, 72) and median time since initial diagnosis was 27 months (IQR: 9, 41). The mean PSQI score was 6.3 (SD: 3.8) and 64% percent of participants met or exceeded the PSQI cut-off score of 5, with a score of 5 or more indicating overall poor sleep quality. In those with poor sleep quality, there were statistically significant detriments in multiple QOL domains. CONCLUSIONS In patients undergoing surveillance for NMIBC, there is a substantial burden of sleep disturbances and resulting decrements in QOL. These data support the need for future interventions to support sleep quality and highlight the importance of addressing sleep health as part of NMIBC survivorship care to improve QOL in patients with NMIBC.
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Affiliation(s)
| | | | - Maxwell V. Meng
- University of California, San Francisco, San Francisco, CA, USA
| | - Stacy Loeb
- New York University Langone Medical Center, New York, NY, USA
| | | | - Sima P. Porten
- University of California, San Francisco, San Francisco, CA, USA
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18
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Loeb S, Sanchez Nolasco T, Siu K, Byrne N, Giri VN. Usefulness of podcasts to provide public education on prostate cancer genetics. Prostate Cancer Prostatic Dis 2023; 26:772-777. [PMID: 36681741 DOI: 10.1038/s41391-023-00648-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Podcasts, or episodic digital audio recordings, represent a novel way to reach large audiences for public education. Genetic evaluation has important implications for prostate cancer (PCa) care but is underutilized. We created a series of five podcasts about PCa genetics and tested their usefulness in raising awareness and providing education to lay audiences. METHODS We recruited 157 men and women from the general public and 100 patients with PCa from across the U.S., who listened to a podcast and completed an online survey. The primary outcome was the perceived usefulness of the podcast (score ≥5 on a published 7-point Likert scale). Secondary outcomes were relevance to informational needs, satisfaction and ease of use, as well as genetic knowledge and attitudes toward genetic testing after listening to the podcasts. RESULTS The podcasts were associated with high mean scores for perceived usefulness (5.6/7), relevance to informational needs (5.6/7), satisfaction (5.8/7), and ease of use (5.9/7). After listening to the podcasts, 80-100% correctly answered most key knowledge questions about PCa genetics, and 85% had a positive attitude toward genetic testing. On multivariable analysis, the perceived usefulness of the podcasts was higher among Black/Hispanic adults (p = 0.05) and those with a family history of PCa (p = 0.01). CONCLUSIONS A podcast series on PCa genetics was perceived as useful and associated with high rates of knowledge for patients with PCa and the general public. Podcasts represent a promising new educational tool to raise awareness about PCa genetic evaluation, particularly for high-risk groups.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University, New York, NY, USA.
- Department of Population Health, New York University, New York, NY, USA.
- The Department of Surgery/Urology, Manhattan Veterans Affairs Medical Center, New York, NY, USA.
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University, New York, NY, USA
- Department of Population Health, New York University, New York, NY, USA
| | - Katherine Siu
- Department of Urology, New York University, New York, NY, USA
- Department of Population Health, New York University, New York, NY, USA
| | - Nataliya Byrne
- Department of Urology, New York University, New York, NY, USA
- Department of Population Health, New York University, New York, NY, USA
| | - Veda N Giri
- The Division of Clinical Cancer Genetics, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA
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19
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Cole AP, Loeb S. Dietary and Lifestyle Recommendations that Align Patient and Planetary Health. Eur Urol Focus 2023; 9:869-872. [PMID: 37770372 DOI: 10.1016/j.euf.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 09/30/2023]
Abstract
Environmental factors such as air pollution and climate change have far-reaching implications for human health, and increasing evidence supports a link between planetary health and many common urological conditions. We summarize these links and outline the data for some dietary and lifestyle changes that have joint benefits for both urological and planetary health. PATIENT SUMMARY: Steps to reduce our impact on the environment can also reduce the risk of urological cancers (bladder, prostate, and kidney cancers), urinary tract infections, kidney stones, and erectile dysfunction, and may have a positive impact on sperm quality. Simple steps such as reducing meat and dairy consumption, increasing exercise levels (e.g. through active commuting), and supporting the preservation of greenspace can benefit both personal health and the environment.
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Affiliation(s)
- Alexander P Cole
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Stacy Loeb
- Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, NY, New York, USA
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20
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Pan A, Musheyev D, Bockelman D, Loeb S, Kabarriti AE. Assessment of Artificial Intelligence Chatbot Responses to Top Searched Queries About Cancer. JAMA Oncol 2023; 9:1437-1440. [PMID: 37615960 PMCID: PMC10450581 DOI: 10.1001/jamaoncol.2023.2947] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/12/2023] [Indexed: 08/25/2023]
Abstract
Importance Consumers are increasingly using artificial intelligence (AI) chatbots as a source of information. However, the quality of the cancer information generated by these chatbots has not yet been evaluated using validated instruments. Objective To characterize the quality of information and presence of misinformation about skin, lung, breast, colorectal, and prostate cancers generated by 4 AI chatbots. Design, Setting, and Participants This cross-sectional study assessed AI chatbots' text responses to the 5 most commonly searched queries related to the 5 most common cancers using validated instruments. Search data were extracted from the publicly available Google Trends platform and identical prompts were used to generate responses from 4 AI chatbots: ChatGPT version 3.5 (OpenAI), Perplexity (Perplexity.AI), Chatsonic (Writesonic), and Bing AI (Microsoft). Exposures Google Trends' top 5 search queries related to skin, lung, breast, colorectal, and prostate cancer from January 1, 2021, to January 1, 2023, were input into 4 AI chatbots. Main Outcomes and Measures The primary outcomes were the quality of consumer health information based on the validated DISCERN instrument (scores from 1 [low] to 5 [high] for quality of information) and the understandability and actionability of this information based on the understandability and actionability domains of the Patient Education Materials Assessment Tool (PEMAT) (scores of 0%-100%, with higher scores indicating a higher level of understandability and actionability). Secondary outcomes included misinformation scored using a 5-item Likert scale (scores from 1 [no misinformation] to 5 [high misinformation]) and readability assessed using the Flesch-Kincaid Grade Level readability score. Results The analysis included 100 responses from 4 chatbots about the 5 most common search queries for skin, lung, breast, colorectal, and prostate cancer. The quality of text responses generated by the 4 AI chatbots was good (median [range] DISCERN score, 5 [2-5]) and no misinformation was identified. Understandability was moderate (median [range] PEMAT Understandability score, 66.7% [33.3%-90.1%]), and actionability was poor (median [range] PEMAT Actionability score, 20.0% [0%-40.0%]). The responses were written at the college level based on the Flesch-Kincaid Grade Level score. Conclusions and Relevance Findings of this cross-sectional study suggest that AI chatbots generally produce accurate information for the top cancer-related search queries, but the responses are not readily actionable and are written at a college reading level. These limitations suggest that AI chatbots should be used supplementarily and not as a primary source for medical information.
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Affiliation(s)
- Alexander Pan
- Department of Urology, State University of New York Downstate Health Sciences University, New York
| | - David Musheyev
- Department of Urology, State University of New York Downstate Health Sciences University, New York
| | - Daniel Bockelman
- Department of Urology, State University of New York Downstate Health Sciences University, New York
| | - Stacy Loeb
- Department of Urology, New York University School of Medicine, New York
- Department of Population Health, New York University School of Medicine, New York
- Department of Surgery, VA New York Harbor Health Care, New York
| | - Abdo E. Kabarriti
- Department of Urology, State University of New York Downstate Health Sciences University, New York
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21
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Cole AP, Gupta N, Loeb S. The Plant-based Prescription: How Dietary Change Can Improve Both Urological and Planetary Health. Eur Urol 2023; 84:357-358. [PMID: 37451898 DOI: 10.1016/j.eururo.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
In this editorial, we discuss the relationship between meat consumption and many major urological conditions (eg, prostate cancer, kidney stones, urinary tract infections) and how dietary choices could simultaneously benefit genitourinary health and the environment, which in turn will have downstream impacts on public health.
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Affiliation(s)
- Alexander P Cole
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Natasha Gupta
- Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA
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22
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Scott C, Campbell P, Nemirovsky A, Loeb S, Malik R. Correction: Prostate cancer and podcasts: an analysis and assessment of the quality of information about prostate cancer available on podcasts. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00721-y. [PMID: 37749168 DOI: 10.1038/s41391-023-00721-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Affiliation(s)
- Colin Scott
- University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Peter Campbell
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amy Nemirovsky
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Stacy Loeb
- New York University Langone Medical Center, New York, NY, USA
| | - Rena Malik
- University of Maryland Medical Center, Baltimore, MD, USA
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23
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Kanner J, Waghmarae S, Nemirovsky A, Wang S, Loeb S, Malik R. TikTok and YouTube Videos on Overactive Bladder Exhibit Poor Quality and Diversity. Urol Pract 2023; 10:493-500. [PMID: 37347790 DOI: 10.1097/upj.0000000000000423] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION We sought to assess the quality, understandability, actionability, and diversity of speakers in videos on TikTok and YouTube regarding overactive bladder. METHODS Using Application Program Interface, the top 500 TikTok and 120 YouTube videos on overactive bladder were retrieved. Videos unrelated to overactive bladder, those not in English, longer than 10 minutes, or lacking both text and audio were excluded. Surgical technique videos for providers were also excluded. Videos were scored by trained raters using 2 validated instruments: PEMAT (Agency for Healthcare Research and Quality's Patient Education Materials Assessment Tool) for actionability and understandability, and the DISCERN instrument for quality of consumer health information. We also examined for evidence of misinformation and commercial bias. RESULTS One hundred thirty-six TikTok videos and 75 YouTube videos met inclusion criteria. Eighty-eight percent of TikTok videos had poor PEMAT actionability scores (a score below 75%), as compared to 60% of YouTube videos. Both YouTube and TikTok videos scored low on PEMAT understandability. Ninety-eight percent of TikTok videos and 65% of YouTube videos were poor quality (DISCERN score <3). YouTube videos had higher actionability and quality than TikTok videos (P < .001) but did not differ on understandability (P = .769). Twenty-three percent of TikTok and 11% of YouTube videos had high misinformation (score >3). Commercial bias was present in 10% of TikTok and 19% of YouTube videos. CONCLUSIONS Actionability, understandability, and quality for overactive bladder-related content is poor on YouTube and TikTok. With increasing access to social media, it is important that health care providers and organizations invest resources in patient education on health literacy.
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Affiliation(s)
- Jenna Kanner
- University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Amy Nemirovsky
- Department of Urology, University of Maryland, Baltimore, Maryland
| | - Shu Wang
- Department of Urology, University of Maryland, Baltimore, Maryland
| | - Stacy Loeb
- Department of Urology and Population Health, New York University, New York, New York
- Department of Surgery, Manhattan Veterans Affairs Medical Center, New York, New York
| | - Rena Malik
- Department of Urology, University of Maryland, Baltimore, Maryland
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24
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Loeb S, Ravenell JE, Gomez SL, Borno HT, Siu K, Sanchez Nolasco T, Byrne N, Wilson G, Griffith DM, Crocker R, Sherman R, Washington SL, Langford AT. The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2324395. [PMID: 37466938 DOI: 10.1001/jamanetworkopen.2023.24395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Importance Black men have a higher risk of prostate cancer compared with White men, but Black adults are underrepresented in online content about prostate cancer. Across racial groups, the internet is a popular source of health information; Black adults are more likely to trust online health information, yet have more medical mistrust than White adults. Objective To evaluate the association between racial representation in online content about prostate cancer and trust in the content and identify factors that influence trust. Design, Setting, and Participants A randomized clinical trial was conducted from August 18, 2021, to January 7, 2022, consisting of a 1-time online survey. Participants included US men and women aged 40 years and older. Data were analyzed from January 2022 to June 2023. Interventions Participants were randomized to watch the same video script about either prostate cancer screening or clinical trials presented by 1 of 4 speakers: a Black physician, a Black patient, a White physician, or a White patient, followed by a questionnaire. Main Outcomes and Measures The primary outcome was a published scale for trust in the information. χ2 tests and multivariable logistic regression were used to compare trust according to the video's speaker and topic. Results Among 2904 participants, 1801 (62%) were men, and the median (IQR) age was 59 (47-69) years. Among 1703 Black adults, a greater proportion had high trust in videos with Black speakers vs White speakers (72.7% vs 64.3%; adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001); less trust with patient vs physician presenter (64.6% vs 72.5%; aOR, 0.63; 95% CI, 0.49-0.80; P < .001) and about clinical trials vs screening (66.3% vs 70.7%; aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, a lower proportion had high trust in videos featuring a patient vs physician (72.0% vs 78.6%; aOR, 0.71; 95% CI, 0.54-0.95; P = .02) and clinical trials vs screening (71.4% vs 79.1%; aOR, 0.57; 95% CI, 0.42-0.76; P < .001), but no difference for Black vs White presenters (76.8% vs 73.7%; aOR, 1.11; 95% CI, 0.83-1.48; P = .49). Conclusions and Relevance In this randomized clinical trial, prostate cancer information was considered more trustworthy when delivered by a physician, but racial concordance was significantly associated with trust only among Black adults. These results highlight the importance of physician participation and increasing racial diversity in public dissemination of health information and an ongoing need for public education about clinical trials. Trial Registration ClinicalTrials.gov Identifier: NCT05886751.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, New York
| | - Joseph E Ravenell
- Department of Population Health, New York University Langone Health, New York
| | - Scarlett Lin Gomez
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Hala T Borno
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
- Trial Library, Inc., San Francisco, California
| | - Katherine Siu
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Nataliya Byrne
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | | | | | - Rob Crocker
- Stakeholder Advisory Board, New York, New York
| | | | - Samuel L Washington
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Aisha T Langford
- Department of Population Health, New York University Langone Health, New York
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25
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Gupta N, Zebib L, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Loeb S. Understanding the sexual health perceptions, concerns, and needs of female partners of prostate cancer survivors. J Sex Med 2023; 20:651-660. [PMID: 36941211 PMCID: PMC10149377 DOI: 10.1093/jsxmed/qdad027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/25/2023] [Accepted: 02/10/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Prostate cancer (PCa) and its treatments can have a significant negative impact on the sexual health of survivors and couples, but few studies have specifically examined the impact of PCa-related sexual dysfunction on female partners of survivors. AIM Our objective was to perform a qualitative study to comprehensively characterize female partners' perceptions of the implications of PCa on their sex lives, as well as partners' sexual health concerns and unmet needs. METHODS We conducted semi-structured telephone interviews about sexual health and unmet needs with female partners of PCa survivors recruited from multiple clinical locations and support groups for PCa caregivers from September 2021 to March 2022. Interviews were audio-recorded, transcribed verbatim, and independently coded. Participants were recruited until thematic saturation was achieved. OUTCOMES Outcomes of this study were female partner sexual health concerns and unmet needs. RESULTS Among 12 participants, the median age was 65 (range 53 to 81) years, 9 were White, the median time since their partner's PCa diagnosis was 2.25 years (range 11 months to 20 years), and a majority reported that their partner had undergone radical prostatectomy, radiation, and/or hormonal therapy. Major emergent themes pertained to the significant impact of age- and PCa-related sexual dysfunction on female sexual quality of life, the dyadic nature of sexual dysfunction and recovery, the role of the partner in coping with and adjusting to sexual dysfunction, difficulties communicating about sexual dysfunction in an intimate relationship, a lack of physician-led sexual health counseling and support, and the benefit of peer interactions and proactive information seeking in addressing unmet sexual health needs. CLINICAL IMPLICATIONS Future efforts should continue to explore the impact of PCa on partner sexual health and address unmet needs through sexual health education and support. STRENGTHS AND LIMITATIONS In this study, we identified female partners' sexual health concerns both related to and independent of PCa survivor sexual health. Limitations include exclusion of male partners of survivors and potential responder bias, as partners who agreed to participate may have experienced more sexual health concerns. CONCLUSION We found that female partners experience PCa-related sexual dysfunction as a couple's disease, grief due to age- and PCa-related sexual losses, and a lack of physician-led sexual health counseling and information. Our results highlight the importance of including partners of PCa survivors in the sexual recovery process and of developing sexual care programs to address partners' unmet sexual health needs.
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Affiliation(s)
- Natasha Gupta
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Tacoma, WA 98431, United States
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Nataliya Byrne
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Stacy Loeb
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
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26
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Leapman MS, Wang R, Loeb S, Seibert TM, Gaylis FD, Lowentritt B, Brown GA, Chen R, Lin D, Witte J, Cooperberg MR, Catalona WJ, Gross CP, Ma X. Use of Monitoring Tests Among Patients With Localized Prostate Cancer Managed With Observation. J Urol 2023; 209:710-718. [PMID: 36753746 DOI: 10.1097/ju.0000000000003159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/30/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE It is unknown whether compliance with recommended monitoring tests during observation of localized prostate cancer has changed over time. MATERIALS AND METHODS We performed a retrospective cohort study of Medicare beneficiaries diagnosed with low- or intermediate-risk prostate cancer in 2004-2016 who were initially managed with observation for a minimum of 12 months. The primary objective was to examine rates of PSA testing, prostate biopsy, and prostate MRI. We used multivariable mixed effects Poisson regression to determine whether rates of PSA testing and prostate biopsy increased over time. In addition, we identified clinical, sociodemographic, and provider factors associated with the frequency of monitoring tests during observation. RESULTS We identified 10,639 patients diagnosed at a median age of 73 (IQR 69-77) years. The median follow-up time was 4.3 (IQR 2.7-6.6) years after diagnosis. Among patients managed without treatment for 5 years, 98% received at ≥1 PSA test, 48.0% ≥1 additional prostate biopsy, and 31.0% ≥1 prostate MRI. Among patients managed with observation for ≥12 months, mixed effects Poisson regression revealed that rates of PSA testing and biopsy increased over time (per calendar year: RR 1.02, 95% CI: 1.02-1.03 and RR 1.10, 95% CI: 1.08-1.11, respectively). Clinical and sociodemographic factors including age, clinical risk, race/ethnicity, census tract poverty, and region were associated with rates of biopsy and PSA testing. CONCLUSIONS Use of recommended monitoring tests including repeat prostate biopsy remains low among Medicare beneficiaries undergoing observation for low- and intermediate-risk prostate cancer.
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Affiliation(s)
- Michael S Leapman
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, Connecticut
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Rong Wang
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, Connecticut
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Stacy Loeb
- Departments of Urology and Population Health, New York University Langone Health, New York, New York
- Manhattan Veterans Affairs Medical Center, New York, New York
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
- Department of Radiology, University of California San Diego, La Jolla, California
- Department of Bioengineering, University of California San Diego, La Jolla, California
| | | | | | | | - Ronald Chen
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas
| | - Daniel Lin
- Department of Urology, University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Public Health Sciences, Seattle, Washington
| | - John Witte
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California
| | - Matthew R Cooperberg
- Department of Urology, University of California San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - William J Catalona
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Cary P Gross
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, Connecticut
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Xiaomei Ma
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, Connecticut
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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27
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Adorno Febles VR, Hao Y, Ahsan A, Wu J, Qian Y, Zhong H, Loeb S, Makarov DV, Lepor H, Wysock J, Taneja SS, Huang WC, Becker DJ, Balar AV, Melamed J, Deng FM, Ren Q, Kufe D, Wong KK, Adeegbe DO, Deng J, Wise DR. Single-cell analysis of localized prostate cancer patients links high Gleason score with an immunosuppressive profile. Prostate 2023; 83:840-849. [PMID: 36988342 DOI: 10.1002/pros.24524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/18/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Evading immune surveillance is a hallmark for the development of multiple cancer types. Whether immune evasion contributes to the pathogenesis of high-grade prostate cancer (HGPCa) remains an area of active inquiry. METHODS Through single-cell RNA sequencing and multicolor flow cytometry of freshly isolated prostatectomy specimens and matched peripheral blood, we aimed to characterize the tumor immune microenvironment (TME) of localized prostate cancer (PCa), including HGPCa and low-grade prostate cancer (LGPCa). RESULTS HGPCa are highly infiltrated by exhausted CD8+ T cells, myeloid cells, and regulatory T cells (TRegs). These HGPCa-infiltrating CD8+ T cells expressed high levels of exhaustion markers including TIM3, TOX, TCF7, PD-1, CTLA4, TIGIT, and CXCL13. By contrast, a high ratio of activated CD8+ effector T cells relative to TRegs and myeloid cells infiltrate the TME of LGPCa. HGPCa CD8+ tumor-infiltrating lymphocytes (TILs) expressed more androgen receptor and prostate-specific membran antigen yet less prostate-specific antigen than the LGPCa CD8+ TILs. The PCa TME was infiltrated by macrophages but these did not clearly cluster by M1 and M2 markers. CONCLUSIONS Our study reveals a suppressive TME with high levels of CD8+ T cell exhaustion in localized PCa, a finding enriched in HGPCa relative to LGPCa. These studies suggest a possible link between the clinical-pathologic risk of PCa and the associated TME. Our results have implications for our understanding of the immunologic mechanisms of PCa pathogenesis and the implementation of immunotherapy for localized PCa.
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Affiliation(s)
- Victor R Adorno Febles
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
- Department of Medicine, Manhattan Campus, VA NY Harbor Health Care System, New York, New York, USA
| | - Yuan Hao
- Applied Bioinformatics Laboratories, New York University Langone Health, New York, New York, USA
| | - Aarif Ahsan
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Jiansheng Wu
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Yingzhi Qian
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Hua Zhong
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Stacy Loeb
- Department of Urology, New York University School of Medicine, New York, New York, USA
- Department of Urology, Manhattan Campus, VA NY Harbor Health Care System, New York, New York, USA
| | - Danil V Makarov
- Department of Urology, New York University School of Medicine, New York, New York, USA
- Department of Urology, Manhattan Campus, VA NY Harbor Health Care System, New York, New York, USA
| | - Herbert Lepor
- Department of Urology, New York University School of Medicine, New York, New York, USA
| | - James Wysock
- Department of Urology, New York University School of Medicine, New York, New York, USA
| | - Samir S Taneja
- Department of Urology, New York University School of Medicine, New York, New York, USA
| | - William C Huang
- Department of Urology, New York University School of Medicine, New York, New York, USA
| | - Daniel J Becker
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
- Department of Medicine, Manhattan Campus, VA NY Harbor Health Care System, New York, New York, USA
| | - Arjun V Balar
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Jonathan Melamed
- Department of Pathology, New York University School of Medicine, New York, New York, USA
| | - Fang-Ming Deng
- Department of Pathology, New York University School of Medicine, New York, New York, USA
| | - Qinghu Ren
- Department of Pathology, New York University School of Medicine, New York, New York, USA
| | - Donald Kufe
- Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Kwok-Kin Wong
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Dennis O Adeegbe
- Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Jiehui Deng
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - David R Wise
- Department of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
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Leapman MS, Loeb S, Cooperberg MR, Catalona WJ, Gaylis FD. A vision for closing the evidence-practice gap in the management of low-grade prostate cancer. JNCI Cancer Spectr 2023; 7:7143751. [PMID: 37101361 PMCID: PMC10133397 DOI: 10.1093/jncics/pkad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 04/28/2023] Open
Affiliation(s)
- Michael S Leapman
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
- Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Stacy Loeb
- Departments of Urology and Population Health, New York University Langone Health; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Matthew R Cooperberg
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - William J Catalona
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Gong F, Loeb S, Siu K, Myrie A, Orstad S, Kenfield SA, Morgans A, Thakker S, Robbins R, Carter P, Jean-Louis G, Nolasco TS, Byrne N, Gupta N. Sleep disturbances are underappreciated in prostate cancer survivorship. Prostate Cancer Prostatic Dis 2023; 26:210-212. [PMID: 36543892 DOI: 10.1038/s41391-022-00630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The prevalence of sleep disturbances among prostate cancer (PCa) survivors, and extent of urologist involvement in sleep care are not well-studied. METHODS PCa survivors (n = 167) and urologists (n = 145) were surveyed about sleep disturbances and survivorship care practices. RESULTS Most PCa survivors had sleep disturbances, including 50.9% with poor sleep quality, 18.0% with clinical/severe insomnia, and 36.5% at high-risk for sleep apnea. Few urologists routinely screened for sleep disturbances, as recommended in national cancer survivorship guidelines. CONCLUSIONS Optimal PCa survivorship care should incorporate screening for sleep disturbances, addressing comorbid factors affecting sleep and referring to sleep medicine when appropriate.
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Affiliation(s)
- Fred Gong
- From SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
| | - Stacy Loeb
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | - Katherine Siu
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | | | - Stephanie Orstad
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | | | - Alicia Morgans
- Dana- Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Rebecca Robbins
- Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Patricia Carter
- The Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA
| | | | - Tatiana Sanchez Nolasco
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | - Nataliya Byrne
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | - Natasha Gupta
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
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30
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Leapman M, Sutherland RA, Gross CP, Ma X, Jeong F, Seibert TM, Cooperberg MR, Catalona W, Loeb S, Schulman-Green D. Patient experiences with tissue-based genomic testing during active surveillance for prostate cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
333 Background: Tissue-based gene expression (genomic) tests improve estimates of prostate cancer aggressiveness and are increasingly used for patients considering or engaged in active surveillance; however, little is known about patient experiences with genomic testing and its role in decision-making for active surveillance. Methods: We performed a qualitative descriptive study consisting of in-depth, semi-structured interviews of patients with low- or favorable-intermediate-risk prostate cancer managed with active surveillance. The interview guide focused on experiences with biopsy-based genomic testing during their decision-making for prostate cancer management. We used purposive sampling to include patients who received genomic testing as part of routine clinical care and we over-sampled Black and Latino men. We continued interviews until thematic saturation was reached, iteratively created a code key and used conventional content data analysis. Results: The mean age was 68 years (range 51-79; n=20). At initial biopsy, 17 (85%) had a Gleason grade group 1, and 3 (15%) had a grade group 2 tumor. Fourteen (70%) participants identified their race/ethnicity as White, 5 (25%) as Black, and 2 (10%) as Latino. The decision to undergo genomic testing was driven by both participants and physicians’ recommendations; however, some participants were unaware that testing had occurred. Overall, participants understood the role of genomic testing in estimating their prostate cancer risk, and the test results increased their confidence in the decision for active surveillance. However, participants did not understand the difference between tissue-based gene expression tests and germline genetic tests, and commonly believed that tissue-based tests measured hereditary cancer risk. While some participants expressed satisfaction with the explanations provided by their physicians, others felt that communication was inaccessible and lacked sufficient detail. Conclusions: Patients interact with and are influenced by the results of biopsy-based genomic testing during active surveillance for prostate cancer, however testing may increase informational needs. Our findings indicate areas for improvement in patient counseling that can be used to increase patient knowledge and comfort with genomic testing.
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Affiliation(s)
| | | | - Cary Philip Gross
- Yale Cancer Outcomes, Public Policy and Effectiveness Research Center, New Haven, CT
| | - Xiaomei Ma
- Yale School of Public Health, New Haven, CT
| | | | | | | | | | - Stacy Loeb
- New York University and Manhattan Veterans Affairs, New York, NY
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Sutherland R, Gross CP, Ma X, Jeong F, Seibert TM, Cooperberg MR, Catalona W, Loeb S, Schulman-Green D, Leapman M. “It just makes sense to me”: Patient experiences with prostate MRI during prostate cancer active surveillance. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
334 Background: Although prostate MRI is commonly used in the diagnosis, staging and active surveillance of prostate cancer, little is known about patient perspectives on MRI imaging. Methods: We performed a qualitative descriptive study consisting of in-depth, semi-structured interviews of patients with low and intermediate risk prostate cancer managed with active surveillance. Interviews focused on experiences with prostate MRI and MRI-ultrasound fusion biopsy during active surveillance monitoring. We purposively sampled patients who received prostate MRI as part of their clinical care, over-sampling Black and Latino men, and conducted interviews until thematic saturation. We performed conventional content analysis to analyze data. Results: The mean sample (n=20) age was 68 years (range 51-79). Fourteen (70%) participants identified as White, 5(25%) as Black, and 2(10%) as Hispanic/Latino. At diagnosis, 17 (85%) had a Gleason grade group 1, and 3 (15%) had a grade group 2 tumor. Overall, participants viewed prostate MRI as a valuable tool that accurately localizes and monitors prostate cancer over time. Prostate MRI was seen as central to active surveillance monitoring. We identified five thematic categories: (1) the experiential aspects of undergoing an MRI scan; (2) the experience of visualizing one’s own prostate and prostate cancer; (3) adequacy of provider explanations of MRI results; (4) confidence in prostate MRI in decision-making; and (5) the role of prostate MRI in longitudinal follow-up during active surveillance, including an interest using MRI to modify the timing of, or replace, prostate biopsy. Conclusions: These findings reveal that patients highly value prostate MRI as a tool that enhances the confidence in the initial diagnosis and monitoring of prostate cancer. This work can inform future studies to optimize the patient experience, education and counseling during active surveillance for prostate cancer.
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Affiliation(s)
| | | | | | | | | | | | | | - Stacy Loeb
- New York University and Manhattan Veterans Affairs, New York, NY
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32
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Giri VN, Gross L, Hartman R, Leader A, Whang YE, Couvillon A, Cheng HH, Paller CJ, Loeb S, Karsh LI, Friedman SJ, Beer TM, Sokolova A, Keith SW. Factors related to men’s experience with prostate cancer germline testing. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
128 Background: Indications for prostate cancer (PCA) germline testing (GT) have greatly expanded, with genetics delivery being implemented in a variety of ways. Here we evaluate factors related to men’s experience with genetic evaluation (GE) in the PCA Genetic Risk, Experience, and Support Study – PROGRESS Registry. Methods: Men took online surveys that covered demographics, PCA history, mode of GE, and measures of patient-reported outcomes (PROs) (satisfaction [Demarco 2004] [Score 6-30; higher=greater satisfaction], decisional conflict [O’Connor 1995] [Score 16-80; higher=greater conflict], attitude re: GT [Marteau 2001] [Score 1-7; higher=perceived benefit], and knowledge of cancer genetics [Erblich 2005] [% correct of 15 questions]). Data were summarized using descriptive statistics. Multiple linear regression modeling assessed relationships between characteristics, mode of GE, and PROs. Significance level was a nominal α = 0.05 (SAS v9.4). Results: PROGRESS reached accrual goal (n=500). Characteristics (among n=414): 87.7% White, 6.0% Asian, 87.7% bachelor’s degree or higher. Among n=422, 46.9% reported PCA diagnosis. Among n=416 who reported genetic results, 27.9% had pathogenic/likely pathogenic variants (P/LPV), 14.7% had VUS, and 9.9% did not know. Mode of GE was delivered: by genetics professional (GP) (24.9% in-person,10.5% phone, 6% telehealth), by doctor (21.1%), from website (20.8%), by genetics lab (5%), and by video (10.8%). Some reported not having pretest discussion (23.7%) or not knowing (8.1%). From multiple regression models, several factors including race, mode of GE, education, and genetic results were related to PROs. Conclusions: Several factors may impact men’s experience with PCA GE, deserving further study into root causes particularly related to diverse populations and genetics care delivery models to support men and their families. [Table: see text]
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Affiliation(s)
- Veda N. Giri
- Yale School of Medicine and Yale Cancer Center, New Haven, CT
| | - Laura Gross
- Thomas Jefferson University, Philadelphia, PA
| | | | - Amy Leader
- Thomas Jefferson University, Philadelphia, PA
| | | | | | | | | | - Stacy Loeb
- New York University and Manhattan Veterans Affairs, New York, NY
| | | | | | | | | | - Scott W. Keith
- Thomas Jefferson University, Department of Pharmacology & Experimental Therapeutics, Philadelphia, PA
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33
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Robbins R, Epstein LJ, Iyer J, Weaver MD, Javaheri S, Fashanu O, Loeb S, Monten K, Le C, Bertisch SM, Van Den Bulck J, Quan SF. Examining understandability, information quality, and presence of misinformation in popular YouTube videos on sleep compared to expert-led videos. J Clin Sleep Med 2023; 19:991-994. [PMID: 36794333 PMCID: PMC10152351 DOI: 10.5664/jcsm.10520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The Internet is a common source of sleep information, but may be subject to commercial bias and misinformation. We compared the understandability, information quality, and presence of misinformation of popular YouTube videos on sleep to videos with credible experts. We identified the most popular YouTube videos on sleep/insomnia and 5 videos from experts. Videos were assessed for understanding and clarity using validated instruments. Misinformation and commercial bias were identified by consensus of sleep medicine experts. The most popular videos received on average 8.2 (±2.2) million views; the expert-led videos received on average 0.3 (±0.2) million views. Commercial bias was identified in 66.7% of popular videos and 0% of expert videos (p<0.012). The popular videos featured more misinformation than expert videos (p<0.001). The popular videos about sleep/insomnia on YouTube featured misinformation and commercial bias. Future research may explore methods for disseminating evidence-based sleep information.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Lawrence J Epstein
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Jay Iyer
- Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, MA
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Sogol Javaheri
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Olabimpe Fashanu
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University School of Medicine and Manhattan Veterans Affairs, New York, NY
| | | | - Colin Le
- Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, MA
| | - Suzanne M Bertisch
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Jan Van Den Bulck
- Department of Media and Communication, University of Michigan, Ann Arbor, MI
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
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Moore CM, King LE, Withington J, Amin MB, Andrews M, Briers E, Chen RC, Chinegwundoh FI, Cooperberg MR, Crowe J, Finelli A, Fitch MI, Frydenberg M, Giganti F, Haider MA, Freeman J, Gallo J, Gibbs S, Henry A, James N, Kinsella N, Lam TBL, Lichty M, Loeb S, Mahal BA, Mastris K, Mitra AV, Merriel SWD, van der Kwast T, Van Hemelrijck M, Palmer NR, Paterson CC, Roobol MJ, Segal P, Schraidt JA, Short CE, Siddiqui MM, Tempany CMC, Villers A, Wolinsky H, MacLennan S. Best Current Practice and Research Priorities in Active Surveillance for Prostate Cancer-A Report of a Movember International Consensus Meeting. Eur Urol Oncol 2023; 6:160-182. [PMID: 36710133 DOI: 10.1016/j.euo.2023.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/06/2022] [Accepted: 01/04/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Active surveillance (AS) is recommended for low-risk and some intermediate-risk prostate cancer. Uptake and practice of AS vary significantly across different settings, as does the experience of surveillance-from which tests are offered, and to the levels of psychological support. OBJECTIVE To explore the current best practice and determine the most important research priorities in AS for prostate cancer. DESIGN, SETTING, AND PARTICIPANTS A formal consensus process was followed, with an international expert panel of purposively sampled participants across a range of health care professionals and researchers, and those with lived experience of prostate cancer. Statements regarding the practice of AS and potential research priorities spanning the patient journey from surveillance to initiating treatment were developed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Panel members scored each statement on a Likert scale. The group median score and measure of consensus were presented to participants prior to discussion and rescoring at panel meetings. Current best practice and future research priorities were identified, agreed upon, and finally ranked by panel members. RESULTS AND LIMITATIONS There was consensus agreement that best practice includes the use of high-quality magnetic resonance imaging (MRI), which allows digital rectal examination (DRE) to be omitted, that repeat standard biopsy can be omitted when MRI and prostate-specific antigen (PSA) kinetics are stable, and that changes in PSA or DRE should prompt MRI ± biopsy rather than immediate active treatment. The highest ranked research priority was a dynamic, risk-adjusted AS approach, reducing testing for those at the least risk of progression. Improving the tests used in surveillance, ensuring equity of access and experience across different patients and settings, and improving information and communication between and within clinicians and patients were also high priorities. Limitations include the use of a limited number of panel members for practical reasons. CONCLUSIONS The current best practice in AS includes the use of high-quality MRI to avoid DRE and as the first assessment for changes in PSA, with omission of repeat standard biopsy when PSA and MRI are stable. Development of a robust, dynamic, risk-adapted approach to surveillance is the highest research priority in AS for prostate cancer. PATIENT SUMMARY A diverse group of experts in active surveillance, including a broad range of health care professionals and researchers and those with lived experience of prostate cancer, agreed that best practice includes the use of high-quality magnetic resonance imaging, which can allow digital rectal examination and some biopsies to be omitted. The highest research priority in active surveillance research was identified as the development of a dynamic, risk-adjusted approach.
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Affiliation(s)
- Caroline M Moore
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospitals Trust, London, UK.
| | | | - John Withington
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Urology, University College London Hospitals Trust, London, UK
| | - Mahul B Amin
- Department of Pathology and Lab Medicine, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Urology, USC Keck School of Medicine, Los Angeles, CA, USA
| | | | | | - Ronald C Chen
- Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Francis I Chinegwundoh
- Department of Urology, Barts Health NHS Trust, London, UK; City University of London, London, UK
| | - Matthew R Cooperberg
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; Department of Urology, University of California at San Francisco, San Francisco, CA, USA
| | - Jane Crowe
- Australian Prostate Centre, North Melbourne, Victoria, Australia
| | - Antonio Finelli
- Department of Surgery (Urology), Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia; Department of Urology, Cabrini Institute, Cabrini Health, Melbourne, Victoria, Australia
| | - Francesco Giganti
- Division of Surgical and Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Masoom A Haider
- Joint Department of Medical Imaging, University Health Network, Sinai Health System and University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | | | - Joseph Gallo
- Active Surveillance Patients International, East Stroudsburg, PA, USA
| | | | | | - Nicholas James
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Netty Kinsella
- Translational Oncology and Urology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Urology, Royal Marsden Hospital, London, UK
| | - Thomas B L Lam
- Academic Urology Unit, Aberdeen University, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Mark Lichty
- Active Surveillance Patients International, East Stroudsburg, PA, USA
| | - Stacy Loeb
- Department of Urology, New York University, New York, NY, USA; Department of Population Health, New York University, New York, NY, USA; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Brandon A Mahal
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | | | - Anita V Mitra
- Cancer Services, University College London Hospitals, NHS, London, UK
| | - Samuel W D Merriel
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter, Exeter, UK; Centre for Primary Care & Health Services Research, University of Manchester, Manchester, UK
| | - Theodorus van der Kwast
- Department of Pathology, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Nynikka R Palmer
- Department of Medicine, Zuckerberg San Francisco General Hospital. University of California San Francisco School of Medicine; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco; Department of Urology, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Catherine C Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia; Canberra Health Services and ACT Health, Synergy Nursing and Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Monique J Roobol
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Phillip Segal
- Prostate Cancer Support Toronto, Toronto, ON, Canada
| | | | - Camille E Short
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia; Melbourne Centre for Behaviour Change, University of Melbourne, Melbourne, Victoria, Australia
| | - M Minhaj Siddiqui
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Clare M C Tempany
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Arnaud Villers
- Department of Urology Univ. Lille, CHU Lille, Department of Urology F-59000 Lille, France
| | - Howard Wolinsky
- Answer Cancer Foundation, Tumacacori, Arizona, USA; TheActiveSurveillor.com, Flossmoor, Illinois, USA
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Gupta N, Kucirka L, Semerjian A, Pierorazio PM, Loeb S, Bivalacqua TJ. Practice Patterns Regarding Female Reproductive Organ-Sparing and Nerve-Sparing Radical Cystectomy Among Urologic Oncologists in the United States. Clin Genitourin Cancer 2023:S1558-7673(23)00032-0. [PMID: 36801170 DOI: 10.1016/j.clgc.2023.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy (RC) techniques have been shown to be oncologically safe and to improve sexual function outcomes among select patients with organ-confined disease. We sought to characterize practice patterns regarding female ROS and nerve-sparing RC among US urologists. PATIENTS AND METHODS We conducted a cross-sectional survey of members of the Society of Urologic Oncology to assess provider-reported frequency of ROS and nerve-sparing RC in premenopausal and postmenopausal patients with non-muscle-invasive bladder cancer that failed intravesical therapy or clinically localized muscle-invasive bladder cancer. RESULTS Among 101 urologists, 80 (79.2%) reported that they routinely resect the uterus/cervix, 68 (67.3%) the neurovascular bundle, 49 (48.5%) the ovaries, and 19 (18.8%) a portion of the vagina when performing RC in premenopausal patients with organ-confined disease. When asked about changes to approach in postmenopausal patients, 71 participants (70.3%) reported that they were less likely to spare the uterus/cervix, 44 (43.6%) were less likely to spare the neurovascular bundle, 70 (69.3%) were less likely to spare the ovaries, and 23 (22.8%) were less likely to spare a portion of the vagina. CONCLUSION We identified significant gaps in adoption of female ROS and nerve-sparing RC techniques for patients with organ-confined disease, despite evidence that ROS and nerve-sparing techniques are oncologically safe and can optimize functional outcomes in select patients. Future efforts should improve provider training in and education about ROS and nerve-sparing RC to improve postoperative outcomes among female patients.
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Affiliation(s)
- Natasha Gupta
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York City, NY.
| | - Lauren Kucirka
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York City, NY
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36
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Leapman MS, Thiel CL, Gordon IO, Nolte AC, Perecman A, Loeb S, Overcash M, Sherman JD. Environmental Impact of Prostate Magnetic Resonance Imaging and Transrectal Ultrasound Guided Prostate Biopsy. Eur Urol 2023; 83:463-471. [PMID: 36635108 DOI: 10.1016/j.eururo.2022.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/17/2022] [Accepted: 12/09/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Reducing low-value clinical care is an important strategy to mitigate environmental pollution caused by health care. OBJECTIVE To estimate the environmental impacts associated with prostate magnetic resonance imaging (MRI) and prostate biopsy. DESIGN, SETTING, AND PARTICIPANTS We performed a cradle-to-grave life cycle assessment of prostate biopsy. Data included materials and energy inventory, patient and staff travel contributed by prostate MRI, transrectal ultrasound guided prostate biopsy, and pathology analysis. We compared environmental emissions across five clinical scenarios: multiparametric MRI (mpMRI) of the prostate with targeted and systematic biopsies (baseline), mpMRI with targeted biopsy cores only, systematic biopsy without MRI, mpMRI with systematic biopsy, and biparametric MRI (bpMRI) with targeted and systematic biopsies. We estimated the environmental impacts associated with reducing the overall number and varying the approach of a prostate biopsy by using MRI as a triage strategy or by omitting MRI. The study involved academic medical centers in the USA, outpatient urology clinics, health care facilities, medical staff, and patients. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Greenhouse gas emissions (CO2 equivalents, CO2e), and equivalents of coal and gasoline burned were measured. RESULTS AND LIMITATIONS In the USA, a single transrectal prostate biopsy procedure including prostate MRI, and targeted and systematic biopsies emits an estimated 80.7 kg CO2e. An approach of MRI targeted cores alone without a systematic biopsy generated 76.2 kg CO2e, a systematic 12-core biopsy without mpMRI generated 36.2 kg CO2e, and bpMRI with targeted and systematic biopsies generated 70.5 kg CO2e; mpMRI alone contributed 42.7 kg CO2e (54.3% of baseline scenario). Energy was the largest contributor, with an estimated 38.1 kg CO2e, followed by staff travel (20.7 kg CO2e) and supply production (11.4 kg CO2e). Performing 100 000 fewer unnecessary biopsies would avoid 8.1 million kg CO2e, the equivalent of 4.1 million liters of gasoline consumed. Per 100 000 patients, the use of prostate MRI to triage prostate biopsy and guide targeted biopsy cores would save the equivalent of 1.4 million kg of CO2 emissions, the equivalent of 700 000 l of gasoline consumed. This analysis was limited to prostate MRI and biopsy, and does not account for downstream clinical management. CONCLUSIONS A prostate biopsy contributes a calculable environmental footprint. Modifying or reducing the number of biopsies performed through existing evidence-based approaches would decrease health care pollution from the procedure. PATIENT SUMMARY We estimated that prostate magnetic resonance imaging (MRI) with a prostate biopsy procedure emits the equivalent of 80.7 kg of carbon dioxide. Performing fewer unnecessary prostate biopsies or using prostate MRI as a tool to decide which patients should have a prostate biopsy would reduce procedural greenhouse gas emissions and health care pollution.
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Affiliation(s)
- Michael S Leapman
- Department of Urology, Yale School of Medicine, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
| | - Cassandra L Thiel
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA; Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | | | | | | | - Stacy Loeb
- Department of Urology, New York University Langone Health, New York, NY, USA; Departments of Urology and Population Health, New York University Langone Health, New York, NY, USA; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | | | - Jodi D Sherman
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
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Martinez-Lopez N, Makarov DV, Thomas J, Ciprut S, Hickman T, Cole H, Fenstermaker M, Gold H, Loeb S, Ravenell JE. A Study to Compare a CHW-Led Versus Physician-Led Intervention for Prostate Cancer Screening Decision-Making among Black Men. Ethn Dis 2023. [DOI: 10.18865/1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Introduction
Prostate cancer is the second leading cause of cancer deaths among men in the United States and harms Black men disproportionately. Most US men are uninformed about many key facts important to make an informed decision about prostate cancer. Most experts agree that it is important for men to learn about these problems as early as possible in their lifetime.
Objectives
To compare the effect of a community health worker (CHW)-led educational session with a physician-led educational session that counsels Black men about the risks and benefits of prostate-specific antigen (PSA) screening.
Methods
One hundred eighteen Black men recruited in 8 community-based settings attended a prostate cancer screening education session led by either a CHW or a physician. Participants completed surveys before and after the session to assess knowledge, decisional conflict, and perceptions about the intervention. Both arms used a decision aid that explains the benefits, risks, and controversies of PSA screening and decision coaching.
Results
There was no significant difference in decisional conflict change by group: 24.31 physician led versus 30.64 CHW led (P=.31). The CHW-led group showed significantly greater improvement on knowledge after intervention, change (SD): 2.6 (2.81) versus 5.1 (3.19), P<.001). However, those in the physician-led group were more likely to agree that the speaker knew a lot about PSA testing (P<.001) and were more likely to trust the speaker (P<.001).
Conclusions
CHW-led interventions can effectively assist Black men with complex health decision-making in community-based settings. This approach may improve prostate cancer knowledge and equally minimize decisional conflict compared with a physician-led intervention.
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Affiliation(s)
| | - Danil V. Makarov
- 1 Department of Population Health, NYU Langone Health, New York, NY
- 2 Department of Urology, NYU Langone Health, New York, NY
- 3 VA New York Harbor Healthcare System, New York, NY
| | - Jerry Thomas
- 1 Department of Population Health, NYU Langone Health, New York, NY
- 3 VA New York Harbor Healthcare System, New York, NY
| | - Shannon Ciprut
- 1 Department of Population Health, NYU Langone Health, New York, NY
- 2 Department of Urology, NYU Langone Health, New York, NY
- 3 VA New York Harbor Healthcare System, New York, NY
| | - Theodore Hickman
- 1 Department of Population Health, NYU Langone Health, New York, NY
| | - Helen Cole
- 1 Department of Population Health, NYU Langone Health, New York, NY
| | | | - Heather Gold
- 1 Department of Population Health, NYU Langone Health, New York, NY
| | - Stacy Loeb
- 1 Department of Population Health, NYU Langone Health, New York, NY
- 2 Department of Urology, NYU Langone Health, New York, NY
- 3 VA New York Harbor Healthcare System, New York, NY
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Li R, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Ness M, Gupta N, Cassidy C, Crisostomo-Wynne T, Loeb S. Unmet Sexual Health Needs of Patients and Female Partners Following Diagnosis and Treatment for Prostate Cancer. J Sex Med 2022; 19:1797-1803. [PMID: 36202730 DOI: 10.1016/j.jsxm.2022.08.195] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prostate cancer (PCa) and its treatment can have significant and pervasive sexual side effects for patients and their partners; however, partner needs are not well understood, and most resources do not incorporate partner priorities. AIM Our objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after PCa diagnosis. METHODS We conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. Overall, 6,193 posts were identified in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% (n = 66) of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. OUTCOMES We assessed sexual health themes among patients and female partners. RESULTS Multiple themes emerged that were unique to female partners of PCa survivors. These included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners also shared common sexual health themes, including coming to terms with changes in sexual function and frustration with clinicians. Both patients and their partners use online health communities to get support and share their experiences with sexual recovery and use of sexual aids. Psychosocial treatments were infrequently mentioned, and may be particularly helpful to address partner concerns. CLINICAL IMPLICATIONS A common concern for couples was not receiving sufficient information from healthcare providers regarding sexual side effects from PCa and its treatment. STRENGTHS AND LIMITATIONS Strengths of the study include leveraging a unique data source to address an understudied topic of sexual health concerns among partners after PCa diagnosis. However, members of an online community may not be representative of all couples facing PCa. Also, this analysis is limited to female partners of patients with PCa, and further study is underway to examine the sexual health needs among gay and bisexual couples. CONCLUSION Both patients and female partners have many unmet sexual health needs during PCa survivorship, and designing interventions to incorporate partner perspectives may improve the management of sexual side effects of PCa for couples. Li R, Wittmann D, Nelson CJ, et al. Unmet Sexual Health Needs of Patients and Female Partners Following Diagnosis and Treatment for Prostate Cancer. J Sex Med 2022;19:1797-1803.
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Affiliation(s)
- Randall Li
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nataliya Byrne
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Tatiana Sanchez Nolasco
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | | | - Natasha Gupta
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Caroline Cassidy
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA.
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Baboudjian M, Breda A, Rajwa P, Gallioli A, Gondran-Tellier B, Sanguedolce F, Verri P, Diana P, Territo A, Bastide C, Spratt DE, Loeb S, Tosoian JJ, Leapman MS, Palou J, Ploussard G. Active Surveillance for Intermediate-risk Prostate Cancer: A Systematic Review, Meta-analysis, and Metaregression. Eur Urol Oncol 2022; 5:617-627. [PMID: 35934625 DOI: 10.1016/j.euo.2022.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
CONTEXT Active surveillance (AS) is increasingly selected among patients with localized, intermediate-risk (IR) prostate cancer (PCa). However, the safety and optimal candidate selection for those with IR PCa remain uncertain. OBJECTIVE To evaluate treatment-free survival and oncologic outcomes in patients with IR PCa managed with AS and to compare with AS outcomes in low-risk (LR) PCa patients. EVIDENCE ACQUISITION A literature search was conducted through February 2022 using PubMed/Medline, Embase, and Web of Science databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed to identify eligible studies. The coprimary outcomes were treatment-free, metastasis-free, cancer-specific, and overall survival. A subgroup analysis was planned a priori to explore AS outcomes when limiting inclusion to IR patients with a Gleason grade (GG) of ≤2. EVIDENCE SYNTHESIS A total of 25 studies including 29 673 unselected IR patients met our inclusion criteria. The 10-yr treatment-free, metastasis-free, cancer-specific, and overall survival ranged from 19.4% to 69%, 80.8% to 99%, 88.2% to 99%, and 59.4% to 83.9%, respectively. IR patients had similar treatment-free survival to LR patients (risk ratio [RR] 1.16, 95% confidence interval (CI), 0.99-1.36, p = 0.07), but significantly higher risks of metastasis (RR 5.79, 95% CI, 4.61-7.29, p < 0.001), death from PCa (RR 3.93, 95% CI, 2.93-5.27, p < 0.001), and all-cause death (RR 1.44, 95% CI, 1.11-1.86, p = 0.005). In a subgroup analysis of studies including patients with GG ≤2 only (n = 4), treatment-free survival (RR 1.03, 95% CI, 0.62-1.71, p = 0.91) and metastasis-free survival (RR 2.09, 95% CI, 0.75-5.82, p = 0.16) were similar between LR and IR patients. Treatment-free survival was significantly reduced in subgroups of patients with unfavorable IR disease and increased cancer length on biopsy. CONCLUSIONS The present systematic review and meta-analysis highlight the need to optimize patient selection for those with IR features. Our findings support limiting the inclusion of IR patients in AS to those with low-volume GG 2 tumor. PATIENT SUMMARY Active surveillance is increasingly used in patients with localized, intermediate-risk (IR) prostate cancer. In this population, we have reported higher risks of metastasis and cancer mortality in unselected patients than in patients with low-risk features, underscoring the need to optimize the selection of patients with IR features.
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Affiliation(s)
- Michael Baboudjian
- Department of Urology, APHM, North Academic Hospital, Marseille, France; Department of Urology, APHM, La Conception Hospital, Marseille, France; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France.
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Andrea Gallioli
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Francesco Sanguedolce
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Medical, Surgical and Experimental Sciences, Université degli Studi di Sassari, Italy
| | - Paolo Verri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Pietro Diana
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Angelo Territo
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Cyrille Bastide
- Department of Urology, APHM, North Academic Hospital, Marseille, France
| | - Daniel E Spratt
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Jeffrey J Tosoian
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Joan Palou
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France; Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
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Abramson M, Feiertag N, Javidi D, Babar M, Loeb S, Watts K. Accuracy of prostate cancer screening recommendations for high-risk populations on YouTube and TikTok. BJUI Compass 2022; 4:206-213. [PMID: 36816146 PMCID: PMC9931542 DOI: 10.1002/bco2.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives This study aimed to evaluate content quality and racial/ethnic representation, particularly of high-risk cohorts, of prostate cancer screening videos on YouTube (YT) and TikTok (TK). Materials and Methods The top 50 videos populated for the search term 'prostate cancer screening' on YT and TK that met inclusion criteria were retrieved in a cache-cleared browser. Three reviewers analysed all videos using validated criteria for the quality of consumer health information (DISCERN and Patient Education Materials Assessment Tool [PEMAT]). High quality was defined as follows: DISCERN ≥ 4, PEMAT understandability ≥75% and PEMAT actionability ≥75%. A 5-point Likert scale was used to demonstrate the level of misinformation compared to American Urological Association and National Comprehensive Cancer Network guidelines. Perceived race and ethnicity of people in the videos were assessed by consensus approach. Results TK videos were shorter (median 3.7 vs. 0.5 min, p < 0.001) and had more views per month (5437.5 vs. 19.3, p = 0.03) than YT videos. Perceived Black and Hispanic representation was present in 10% and 6% of YT videos and 20% and 12% of TK videos, respectively. High-risk racial/ethnic groups were explicitly discussed in 46% of YT videos and 8% of TK videos. A total of 98% of YT videos and 100% of TK videos had low- to moderate-quality consumer health information, and 88% of YT videos and 100% of TK videos had moderate to high levels of misinformation based on screening guidelines. Conclusions YT and TK videos about prostate cancer screening are widely viewed but do not provide quality consumer health information. Black and Hispanic men remain under-represented on both platforms, and high-risk racial groups were not discussed in most videos despite the importance for screening criteria. The low understandability and actionability, significant misinformation and lack of diversity in online videos support the need for higher quality videos with adequate attention to high-risk ethnic cohorts.
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Affiliation(s)
- Max Abramson
- Albert Einstein College of MedicineBronxNew YorkUSA
| | | | | | | | - Stacy Loeb
- Departments of Urology and Population HealthNew York University Langone Health and Manhattan Veterans Affairs Medical CenterNew YorkNew YorkUSA
| | - Kara Watts
- Albert Einstein College of MedicineBronxNew YorkUSA,Department of Urology, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
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Wittmann D, Mehta A, McCaughan E, Faraday M, Duby A, Matthew A, Incrocci L, Burnett A, Nelson CJ, Elliott S, Koontz BF, Bober SL, McLeod D, Capogrosso P, Yap T, Higano C, Loeb S, Capellari E, Glodé M, Goltz H, Howell D, Kirby M, Bennett N, Trost L, Odiyo Ouma P, Wang R, Salter C, Skolarus TA, McPhail J, McPhail S, Brandon J, Northouse LL, Paich K, Pollack CE, Shifferd J, Erickson K, Mulhall JP. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022; 19:1655-1669. [PMID: 36192299 DOI: 10.1016/j.jsxm.2022.08.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/18/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships. AIM We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients' and partners' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship. METHODS The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR). OUTCOMES Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel. RESULTS The guidelines account for patients' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship. CLINICAL IMPLICATIONS The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer. STRENGTHS & LIMITATIONS The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries. CONCLUSION The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research. Wittmann D, Mehta A, McCaughan E, et al. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022;19:1655-1669.
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Affiliation(s)
- Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI, USA.
| | - Akanksha Mehta
- Department of Urology, Emory University, Atlanta, GA, USA
| | - Eilis McCaughan
- In Memoriam, Ulster University School of Nursing, County Londonderry, Colraine, UK
| | | | - Ashley Duby
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Matthew
- Adult Psychiatry and Health System, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Luca Incrocci
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Arthur Burnett
- Department of Urology, Johns Hopkins University, Baltimore, MD, USA
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stacy Elliott
- Departments of Psychiatry and Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | | | - Sharon L Bober
- Department of Psychiatry, Dana Farber Cancer Institute and Harvard University, Boston, MA, USA
| | - Deborah McLeod
- School of Nursing, NS Health Authority and Dalhousie University, Halifax, NS, Canada
| | - Paolo Capogrosso
- Department of Urology, Ciircolo & Fondazione Macchi Hospital, University of Insubria, Varese, Lombardy, Italy
| | - Tet Yap
- Department of Urology, Guys & St Thomas' Hospital, City of London, London, UK
| | - Celestia Higano
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Stacy Loeb
- Department of Urology at NYU Grossman School of Medicine, New York, NY, USA
| | - Emily Capellari
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Michael Glodé
- Department of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA
| | - Heather Goltz
- School of Social Work, University of Houston-Downtown, Houston, TX, USA
| | - Doug Howell
- Patient with Lived Experience, Keaau, HI, USA
| | - Michael Kirby
- Faculty of the Health and Human Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Nelson Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Landon Trost
- Department of Urology, Brigham Young University, Provo, UT, USA; Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | - Run Wang
- Department of Surgery-Urology, University of Texas McGovern Medical School, Houston, TX, USA; Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Carolyn Salter
- Department of Urology, Madigan Army Medical Center, Tacoma, WA, USA
| | - Ted A Skolarus
- Department of Urology, University of Michigan, Ann Arbor, MI, USA; VA Health Services Research & Development, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - John McPhail
- Patient and Partner with Lived Experience, Okemos, MI, USA
| | - Susan McPhail
- Patient and Partner with Lived Experience, Okemos, MI, USA
| | - Jan Brandon
- Partner with Lived Experience, Nashville, TN, USA
| | | | - Kellie Paich
- Clinical Quality and Survivorship, Movember Foundation, Culver City, CA, USA
| | - Craig E Pollack
- Department of Health Policy Management, Johns Hopkins University, Baltimore, MD, USA
| | - Jen Shifferd
- Department of Physical Therapy and Rehabilitation Medicine, Michigan Medicine Therapy Services, Ann Arbor, MI, USA
| | - Kim Erickson
- Department of Physical Therapy and Rehabilitation Medicine, Michigan Medicine Therapy Services, Ann Arbor, MI, USA
| | - John P Mulhall
- Department of Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Burg ML, Sholklapper T, Kohli P, Kaneko M, Maria Autran A, Teoh J, Murphy DG, Samplasky M, Psutka SP, Loeb S, Ribal MJ, Cacciamani GE. Gender Disparities Among Editorial Boards of International Urology Journals. Eur Urol Focus 2022; 8:1840-1846. [PMID: 35504837 DOI: 10.1016/j.euf.2022.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Gender composition among surgical academic leadership, including academic medical journals, disproportionately favors men and may inadvertently introduce a bias. An understanding of the factors associated with gender representation among urologic journals may aid in prioritizing an equitable balance. OBJECTIVE To evaluate female representation on editorial boards of pre-eminent international urologic journals. DESIGN, SETTING, AND PARTICIPANTS The names and position descriptions of urologic journal leadership appointees were collected in October 2021. Gender was assessed using gender-api.com or through personal title, as available. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted from Scopus journal data. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A multivariate logistic regression analysis was performed to describe associations between SCImago Journal Rank (SJR) quartile and geographic region with female gender representation. Quartile 1 (Q1) was considered the top quartile and Q4 the bottom quartile concordant with journal impact factor. RESULTS AND LIMITATIONS A total of 105 urology-focused journals were identified with 5989 total editorial board members, including 877 (14.6%) female, 5112 (85.4%) male, and two nonbinary persons. Female representation differed significantly by journal leadership position, SJR quartile, and geographic region. On the multivariate analysis of overall female representation, Q1 journals had higher odds of female representation than Q2 and Q3 journals, and had no significant difference from Q4 journals. Additionally, compared with Western Europe, North American journals had 78% higher odds while Asiatic journals had 50% lower odds of female representation. This study is limited by the inability to account for outside factors that lead to invitation or acceptance of journal leadership positions. CONCLUSIONS Contemporary female leadership at urology journals is about six times less common than male leadership across all journals, although trends in their proportion were noted when assessed by journal quartile and region. Addressing this gender imbalance represents an important step toward achieving gender equity in the field of urology. PATIENT SUMMARY In this study, we looked at the gender balance of academic journal leaders who serve as gatekeepers for sharing urologic research with the public. We found that the most prestigious journals and those in western countries tended to have the highest female representation. We hope that these findings help the academic community recognize and improve gender representation.
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Affiliation(s)
- Madeleine L Burg
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tamir Sholklapper
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Priya Kohli
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Masatomo Kaneko
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana Maria Autran
- Oficina de Investigacion CAU (Confederacion Americana de Urologia), Madrid, Spain
| | - Jeremy Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mary Samplasky
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Stacy Loeb
- Departments of Urology and Population Health, New York University Langone Health, New York, NY, USA; Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; European Association of Urology - Young Academic Urologist (EAU-YAU), Arnhem, The Netherlands.
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Teoh JYC, Bhatt NR, Cucchiara V, Garcia Rojo E, Pradere B, Borgmann H, Loeb S, Kutikov A, Ribal MJ, Giannarini G. The Power of Hashtags in Social Media: Lessons Learnt from the Urology Tag Ontology Project. Eur Urol Focus 2022; 8:1565-1567. [PMID: 35668025 DOI: 10.1016/j.euf.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
Standardisation of hashtags for urologic diseases in the Urology Tag Ontology (UTO) project has facilitated more efficient filtering of social media content. Hashtags must be recognisable and easy to understand. The UTO list should be expanded to include hashtags for urologic procedures and the hashtags could be used on social media platforms other than Twitter to reach a wider audience.
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Affiliation(s)
- Jeremy Yuen-Chun Teoh
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China.
| | | | - Vito Cucchiara
- Department of Urology, Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - Hendrik Borgmann
- Department of Urology, University Hospital Medical School Brandenburg, Germany
| | - Stacy Loeb
- Department of Urology and Population Health, New York University Langone Health, New York, NY, USA; Manhattan Veterans Affairs, New York, NY, USA
| | - Alexander Kutikov
- Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Maria J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Gianluca Giannarini
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
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Corsi N, Nguyen DD, Butaney M, Majdalany SE, Corsi MP, Malchow T, Piontkowski AJ, Trinh QD, Loeb S, Abdollah F. Top 100 Urology Influencers on Twitter: Is Social Media Influence Associated with Academic Impact? Eur Urol Focus 2022; 9:396-402. [PMID: 36210295 DOI: 10.1016/j.euf.2022.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/01/2022] [Accepted: 09/14/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Social media use in medicine has exploded, with uptake by most physicians and patients. There is a risk of dissemination of inaccurate information about urological conditions on social media. Physicians, as key opinion leaders, must play a role in sharing evidence-based information through social media. OBJECTIVE To identify and describe the top 100 urology influencers on the Twitter social media platform and to correlate Twitter influence with academic impact in urology. DESIGN, SETTING, AND PARTICIPANTS Twitter influence scores for the search topic "urology" were collected in April 2022 using published methodology. The top 100 personal accounts with the highest computed scores were linked to individuals' names, all-time h index, geographic location, specialty, attributed sex, and board certification status in this cross-sectional study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We examined the correlation between influence rank and h index. RESULTS AND LIMITATIONS Of the top 100 Twitter influencers on the topic of urology, the majority are from the USA (64%), male (85%), and practicing urologists (91%). Some 93% of US urology influencers are board-certified. Only 22 of the 50 US states are represented. The second most frequent country is the UK, with ten urology influencers. The median all-time h index is 42 (interquartile range 28.25-58). There is a weak positive correlation between influence rank and h index (r = 0.23; p = 0.02). Limitations of the study include the inability to validate the accuracy of the proprietary ranking algorithm and investigation of just one social media platform. CONCLUSIONS The top Twitter influencers in urology are mostly board-certified US urologists. Collectively, influencers have a relatively greater academic impact in comparison to the average urologist, although there is a weak positive correlation between Twitter influence and h index among top Twitter influencers. PATIENT SUMMARY Given the explosion of medical information on Twitter, we report the personal accounts with the greatest impact for the topic of "urology". We found that most urology influencers on Twitter are US board-certified urologists with a strong research history.
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Yang H, Breyer BN, Rimm EB, Giovannucci E, Loeb S, Kenfield SA, Bauer SR. Plant-based diet index and erectile dysfunction in the Health Professionals Follow-Up Study. BJU Int 2022; 130:514-521. [PMID: 35484829 PMCID: PMC9474604 DOI: 10.1111/bju.15765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the longitudinal association between plant-based diet index (PDI) score and incident erectile dysfunction (ED). MATERIALS AND METHODS We conducted a prospective analysis of 21 942 men aged 40 to 75 years who were enrolled in the Health Professionals Follow-Up Study. ED was assessed with questionnaires every 4 years starting in 2000. Dietary data were collected via validated food frequency questionnaires completed every 4 years and were used to calculate total PDI scores, as well as healthy (hPDI) and unhealthy (uPDI) subscores. Multivariable Cox proportional hazards models were used to compute hazard ratios (HRs) for incident ED. All models were stratified by age (<60, 60 to <70, ≥70 years). RESULTS Among men aged 60 to <70 years, hPDI was inversely associated with incident ED. Those in the highest quintile of hPDI in that age group had an 18% lower risk of ED (HR 0.82, 95% confidence interval (CI) 0.73-0.91; P-trend <0.001) compared to those in the lowest quintile. Conversely, uPDI was positively associated with ED in men aged <60 years (HR 1.27, 95% CI 1.01-1.60; P-trend = 0.02). CONCLUSIONS Encouraging a healthy plant-based diet may be an environmentally sustainable intervention for men interested in maintaining erectile function.
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Affiliation(s)
| | | | - Eric B. Rimm
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - Edward Giovannucci
- Departments of Nutrition & Epidemiology, Harvard T.H. Chan School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs
| | - Stacey A. Kenfield
- Department of Urology, UCSF
- Department of Epidemiology & Biostatistics, UCSF
| | - Scott R. Bauer
- Department of Urology, UCSF
- Division of General Internal Medicine, Department of Medicine, UCSF
- San Francisco Veterans Affairs Healthcare System
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46
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Gedeborg R, Loeb S, Styrke J, Kiiski-Berggren R, Garmo H, Stattin P. Susceptibility to SARS-Cov-2 Infection and Risk for Severe COVID-19 in Patients with Prostate Cancer on Androgen Deprivation Therapy. Int J Cancer 2022; 151:1925-1934. [PMID: 35802468 PMCID: PMC9349425 DOI: 10.1002/ijc.34204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 11/07/2022]
Abstract
Androgen deprivation therapy (ADT) has been hypothesized to protect against COVID‐19, but previous observational studies of men with prostate cancer on ADT have been inconsistent regarding mortality risk from coronavirus disease 2019 (COVID‐19). Using data from the Prostate Cancer data Base Sweden (PCBaSe), we identified a cohort of 114 547 men with prevalent prostate cancer on the start of follow‐up in February 2020, and followed them until 16 December 2020 to evaluate the association between ADT and time to test positive for COVID‐19. Among men testing positive for COVID‐19, we used regression analyses to estimate the association between ADT and risk of COVID‐19‐related hospital admission/death from any cause within 30 days of the positive test. In total, 1695 men with prostate cancer tested positive for COVID‐19. In crude analyses, exposure to ADT was associated with a 3‐fold increased risk of both testing positive for COVID‐19 infection and subsequent hospital admission/death. Adjustment for age, comorbidity and prostate cancer risk category substantially attenuated the associations: HR 1.3 (95% CI: 1.1‐1.5) for testing positive for COVID‐19, and OR 1.4 (95% CI: 1.0‐1.9) for risk of subsequent hospital admission/death. In conclusion, although these results suggest increased risks of a positive COVID‐19 test, and COVID‐19‐related hospital admission/death in men on ADT, these findings are likely explained by confounding by old age, cancer‐associated morbidity and other comorbidities being more prevalent in men on ADT, rather than a direct effect of the therapy.
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Affiliation(s)
- Rolf Gedeborg
- Department of Surgical Sciences, Uppsala University, Uppsala
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, New York
| | - Johan Styrke
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Ritva Kiiski-Berggren
- Dept of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden
| | - Hans Garmo
- Department of Surgical Sciences, Uppsala University, Uppsala.,Translational Oncology and Urology Research (TOUR), King's College London, Guy's Hospital, London, UK
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala
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Gupta N, Patel HD, Taylor J, Borin JF, Jacobsohn K, Kenfield SA, Eggener SE, Price C, Davuluri M, Byrne N, Bivalacqua TJ, Loeb S. Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes. Prostate Cancer Prostatic Dis 2022; 25:444-452. [PMID: 35790788 DOI: 10.1038/s41391-022-00553-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 04/26/2022] [Accepted: 05/11/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Plant-based diets are increasingly popular and have many well-established benefits for health and environmental sustainability. Our objective was to perform a systematic review of plant-based diets and prostate cancer. METHODS We performed a systematic database and citation search in February 2022. Studies were included if they reported primary data on plant-based dietary patterns (i.e., vegan, vegetarian, plant-based) and incidence among at-risk men for prostate cancer, or oncologic, general health/nutrition, or quality of life outcomes among patients with prostate cancer or caregivers. RESULTS A total of 32 publications were eligible for the qualitative synthesis, representing 5 interventional and 11 observational studies. Interventional studies primarily focused on lifestyle modification including plant-based diets for men on active surveillance for localized prostate cancer or with biochemical recurrence after treatment, showing improvements in short-term oncologic outcomes alongside improvements in general health and nutrition. Observational studies primarily focused on prostate cancer risk, showing either protective or null associations for plant-based dietary patterns. Studies of the vegan diet consistently showed favorable associations with risk and/or outcomes. Gaps in the current literature include impact for long-term disease-specific outcomes. CONCLUSIONS Interventional studies showed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Observational studies demonstrated either a lower risk of prostate cancer or no significant difference. These results are encouraging in light of the many benefits of plant-based diets for overall health, as well as environmental sustainability and animal welfare.
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Affiliation(s)
- Natasha Gupta
- Department of Urology, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA. .,Population Health, NYU Langone Health, New York, NY, USA.
| | - Hiten D Patel
- Department of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - Jacob Taylor
- Department of Urology, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA
| | - James F Borin
- Department of Urology, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA
| | - Kenneth Jacobsohn
- Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stacey A Kenfield
- Departments of Urology and Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | | | - Carrie Price
- Albert S. Cook Library, Towson University, Towson, MD, USA
| | - Meena Davuluri
- Department of Urology, Weill Cornell Medical Center, New York, NY, USA
| | - Nataliya Byrne
- Department of Urology, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA.,Population Health, NYU Langone Health, New York, NY, USA
| | | | - Stacy Loeb
- Department of Urology, NYU Langone Health and Manhattan Veterans Affairs, New York, NY, USA.,Population Health, NYU Langone Health, New York, NY, USA
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Bukavina L, Dubin J, Isali I, Calaway A, Mortach S, Loeb S, Kutikov A, Mishra K, Sindhani M, Adan F, Ponsky L. Twitter Footprint and the Match in the COVID-19 Era: Understanding the Relationship between Applicant Online Activity and Residency Match Success. Urol Pract 2022; 9:331-339. [PMID: 37145779 DOI: 10.1097/upj.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/15/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The dramatic reduction of clinical and research activities within medical and surgical departments during COVID-19, coupled with the inability of medical students to engage in research, away rotations and academic meetings, have all posed important implications on residency match. METHODS Using Twitter application programming interface available data, 83,000 program-specific and 28,500 candidate-specific tweets were extracted for the analysis. Applicants to urology residency were identified as matched vs unmatched based on 3-level identification and verification. All elements of microblogging were captured through Anaconda Navigator. The primary endpoint was residency match, assessed as correlation to Twitter analytics (ie retweets, tweets). The final list of matched/unmatched applicants through this process was cross-referenced with internal validation of information obtained from the American Urological Association. RESULTS A total of 28,500 English language posts from 250 matched and 45 unmatched applicants were included in the analysis. Matched applicants generally showed higher number of followers (median 171 [IQR 88-317.5] vs 83 [42-192], p=0.001), tweet likes (2.57 [1.53-4.52] vs 1.5 [0.35-3.03], p=0.048), and recent and total manuscripts (1 [0-2] vs 0 [0-1], p=0.006); 1 [0-3] vs 0 [0-1], p=0.016) in comparison to the unmatched cohort. On multivariable analysis, after adjusting for location, total number of citations and manuscripts, being a female (OR 4.95), having more followers (OR 1.01), individual tweet likes (OR 1.011) and total number of tweets (OR 1.02) increased overall odds of matching into a urology residency. CONCLUSIONS Our study of the 2021 urology residency application cycle and use of Twitter highlighted distinct differences among matched and unmatched applicants and their respective Twitter analytics, highlighting a potential professional development opportunity offered by social media in underscoring applicants' profiles.
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Affiliation(s)
- Laura Bukavina
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- Case Western School of Medicine, Cleveland, Ohio
- Department of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Justin Dubin
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ilaha Isali
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Adam Calaway
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- Case Western School of Medicine, Cleveland, Ohio
| | | | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, New York
| | - Alexander Kutikov
- Department of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | | | | | - Françoise Adan
- Connor Integrative Health Network, University Hospitals, Cleveland, Ohio
| | - Lee Ponsky
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
- Case Western School of Medicine, Cleveland, Ohio
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Loeb S, Cheng HH, Leader A, Gross L, Nolasco TS, Byrne N, Wise DR, Hollifield L, Brown LH, Slater E, Pieczonka C, Gomella LG, Kelly WK, Trabulsi EJ, Handley N, Lallas CD, Chandrasekar T, Mille P, Mann M, Mark JR, Brown G, Chopra S, Wasserman J, Phillips J, Somers P, Giri VN. Technology-enhanced AcceleRation of Germline Evaluation for Therapy (TARGET): A randomized controlled trial of a pretest patient-driven webtool vs. genetic counseling for prostate cancer germline testing. Contemp Clin Trials 2022; 119:106821. [PMID: 35710085 DOI: 10.1016/j.cct.2022.106821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Germline testing has an increasingly important role in prostate cancer care. However, a relative shortage of genetic counselors necessitates alternate strategies for delivery of pre-test education for germline testing. This study, funded by the Prostate Cancer Foundation, seeks to address the need for novel methods of delivery of pre-test germline education beyond traditional germline counseling to facilitate informed patient decision-making for germline testing. METHODS This is a two-armed randomized controlled trial (RCT) with a target enrollment of 173 participants with prostate cancer per study arm (total anticipated n = 346). Patients who meet criteria for germline testing based on tumor features, family history or Ashkenazi Jewish ancestry are being recruited from 5 US sites including academic, private practice and Veterans healthcare settings. Consenting participants are randomized to the interactive pretest webtool or germline counseling with assessment of key patient-reported outcomes involved in informed decision-making for germline germline testing. RESULTS Participants complete surveys at baseline, after pretest education/counseling, and following disclosure of germline germline results. The primary outcome of the study is decisional conflict for germline testing. Secondary outcomes include germline knowledge, satisfaction, uptake of germline testing, and understanding of results. CONCLUSION Our hypothesis is that the web-based germline education tool is non-inferior to traditional germline counseling regarding key patient-reported outcomes involved in informed decision-making for germline testing. If proven, the results would support deploying the webtool across various practice settings to facilitate pre-test germlines education for individuals with prostate cancer and developing collaborative care strategies with germline counseling. CLINICALTRIALS gov Identifier: NCT04447703.
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Affiliation(s)
- Stacy Loeb
- NYU-Langone Health and NYU Perlmutter Cancer Center, New York, NY, United States of America; Manhattan Veteran Affairs, New York, NY, United States of America
| | - Heather H Cheng
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, United States of America
| | - Amy Leader
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Laura Gross
- Cancer Risk Assessment and Clinical Cancer Germlines, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Tatiana Sanchez Nolasco
- NYU-Langone Health and NYU Perlmutter Cancer Center, New York, NY, United States of America; Manhattan Veteran Affairs, New York, NY, United States of America
| | - Nataliya Byrne
- NYU-Langone Health and NYU Perlmutter Cancer Center, New York, NY, United States of America; Manhattan Veteran Affairs, New York, NY, United States of America
| | - David R Wise
- NYU-Langone Health and NYU Perlmutter Cancer Center, New York, NY, United States of America
| | - Lucas Hollifield
- NYU-Langone Health and NYU Perlmutter Cancer Center, New York, NY, United States of America
| | - Lauren H Brown
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, United States of America
| | - Elias Slater
- Prostate Cancer Foundation, Santa Monica, CA, United States of America
| | | | - Leonard G Gomella
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - William K Kelly
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Edouard J Trabulsi
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Nathan Handley
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Costas D Lallas
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Thenappan Chandrasekar
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Patrick Mille
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Mark Mann
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - James Ryan Mark
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Gordon Brown
- New Jersey Urology, Voorhees, NJ, United States of America
| | - Sameer Chopra
- New Jersey Urology, Voorhees, NJ, United States of America
| | - Jenna Wasserman
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Jade Phillips
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Patrick Somers
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Veda N Giri
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America; Cancer Risk Assessment and Clinical Cancer Germlines, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States of America; Department of Urology, Thomas Jefferson University, Philadelphia, PA, United States of America.
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Thakker S, Robbins R, Carter P, Jean‐Louis G, Siu K, Sanchez Nolasco T, Byrne N, Orstad SL, Myrie A, Loeb S. Research communication: Poor sleep health and quality of life among caregivers of patients with prostate cancer. BJUI Compass 2022; 3:331-333. [PMID: 35950040 PMCID: PMC9349590 DOI: 10.1002/bco2.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Rebecca Robbins
- Division of Sleep Medicine Harvard Medical School Boston Massachusetts USA
- Department of Medicine, Division of Sleep and Circadian Disorders Brigham & Women's Hospital Boston Massachusetts USA
| | - Patricia Carter
- Capstone College of Nursing University of Alabama Tuscaloosa Alabama USA
| | - Girardin Jean‐Louis
- Departments of Psychiatry and Neurology, Miller School of Medicine University of Miami Miami Florida USA
| | - Katherine Siu
- Departments of Urology and Population Health NYU Langone Health New York New York USA
| | | | - Nataliya Byrne
- Departments of Urology and Population Health NYU Langone Health New York New York USA
| | - Stephanie L. Orstad
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation NYU Grossman School of Medicine New York New York USA
| | - Akya Myrie
- Department of Urology Cleveland Clinic Cleveland Ohio USA
| | - Stacy Loeb
- Departments of Urology and Population Health NYU Langone Health New York New York USA
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