Expanding the definition of quality of life for prostate cancer.
BACKGROUND
Quality of life in prostate cancer is a multidimensional concept. From a social work perspective, three quality-of-life issues require additional consideration. These are: the impact of the disease and its treatment on family caregivers, the possibility of age bias and ethical dilemmas in treatment decisions, and the specific concerns of black men in whom the disease is more common.


METHODS
Oncology and social work literature was reviewed.


RESULTS
Studies of caregivers of elderly patients contribute to understanding the stress and anxieties of families, one of whose members has prostate cancer as a chronic illness. Current debates on expectant management and advanced directives provoke ethical concerns about when to treat prostate cancer especially in elderly patients. A growing appreciation of black health practices and social supports must be considered along with the socioeconomic factors that may inhibit or promote access to care.


CONCLUSIONS
Social workers can assist the treatment team in understanding the importance of these factors for specific patients. Additional research is needed on the effect of these issues on access to care, physician-patient-family communication, long-term treatment plans, and outcome.
Sharp
J W
JW
Social Work Department, Cleveland Clinic Foundation, OH 44195-5195.
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D017028:Caregivers; D004992:Ethics, Medical; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000451:nursing / Q000523:psychology; D011788:Quality of Life; D012959:Socioeconomic Factors