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Grant Details

Grant Number: 5R01CA218657-05 Interpret this number
Primary Investigator: Rosser, B R Simon
Organization: University Of Minnesota
Project Title: RESTORE: Improving Sexual Outcomes of Gay and Bisexual Prostate Cancer Survivors
Fiscal Year: 2021


Abstract

Abstract: This application, in response to PA-15-261, “Research leading to interventions to ameliorate health disparities of sexual and gender minorities”, advances research in three areas. First, prostate cancer (PCa) is the second most common cancer among gay, bisexual, and other men who have sex with men (GBM), with documented disparities, yet it is severely under-researched. Because gay sex differs from vaginal sex, physiologically; the results from 614 studies focused on heterosexual men likely do not generalize to GBM with PCa. There have been no rehabilitation studies specific to GBM survivors of PCa, so clinicians have no relevant studies to inform best practice with their GBM patients. Second, most PCa studies have tested one or rehabilitation components. We will conduct the first treatment study of a state of clinical practice comprehensive rehabilitation program on GBM's quality of life, including on both urinary and sexual function and bother measures. Third, almost all PCa studies have focused on men recently treated for PCa. We will study both GBM recently treated (last 2 years) and GBM post-treatment (2+ years), using a stratified design. This study builds on our findings in Restore, an R21 which was only the second study of GBM with PCa to be funded by NCI, and the first to reach publication. We conducted N=41 in-depth qualitative interviews with good saturation, and the largest quantitative study of GBM with PCa to date (N=193), the first needs assessment of GBM with PCa, and the first study of same sex partners and care-givers of GBM. Participants described radical prostatectomy as leaving them “humiliated,” “maimed”, “less than other gay men,” and “severely depressed.” Most (88%) reported ongoing sexual challenges contributing to decreased quality of life, poorer mental health, identity challenges and deteriorated primary relationships. Only three of the eight (38%) outcomes commonly experienced by most GBM were discussed as part of treatment. There was no evidence of any standard of professional rehabilitation; indeed, most GBM just treated themselves. The long-term objective of this research is to improve the health of GBM survivors of PCa and to provide an evidence base for rehabilitation. In Aim I, we will develop an online rehabilitation program tailored for GBM that addresses both the sexual and urinary effects of PCa treatment. In Aim II, we will conduct a comparative recruitment study to identify best methods to recruit 450 GBM with PCa. In Aim III, we will evaluate the effects of the tailored rehabilitation program on sexual and urinary outcomes. We will conduct a 24 month, randomized controlled trial of structured rehabilitation versus routine care. This RCT will identify whether a structured rehabilitation program is effective in addressing the major sexual and urinary problems caused by PCa treatment. As the first treatment study to focus on GBM with PCa (and also on oral and anal sex), it addresses a long-standing health disparity. The study has high potential to transform rehabilitation for GBM with PCa, provide a critical evidence base for clinicians, and inform rehabilitation outcomes for all PCa survivors.



Publications

Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the Restore-2 Rehabilitation Trial for gay and bisexual prostate cancer patients.
Authors: Simon Rosser B.R. , Wright M. , Hoefer C.J. , Polter E.J. , Kohli N. , Wheldon C.W. , Haggart R. , Talley K.M. , Mitteldorf D. , Kilian G. , et al. .
Source: Clinical trials (London, England), 2022 Jun; 19(3), p. 239-250.
EPub date: 2022-03-01.
PMID: 35232299
Related Citations

Creation and Psychometric Validation of the Sexual Minorities and Prostate Cancer Scale (SMACS) in Sexual Minority Patients-The Restore-2 Study.
Authors: Polter E.J. , Kohli N. , Rosser B.R.S. , Talley K.M.C. , Wheldon C.W. , Hoefer C.J. , Wright M. , Haggart R. , Mitteldorf D. , Kilian G. , et al. .
Source: The journal of sexual medicine, 2022 Mar; 19(3), p. 529-540.
EPub date: 2022-02-04.
PMID: 35131199
Related Citations

Health Disparities of Sexual Minority Patients Following Prostate Cancer Treatment: Results From the Restore-2 Study.
Authors: Rosser B.R.S. , Polter E.J. , Talley K.M.C. , Wheldon C.W. , Haggart R. , Wright M. , West W. , Mitteldorf D. , Ross M.W. , Konety B.R. , et al. .
Source: Frontiers in oncology, 2022; 12, p. 812117.
EPub date: 2022-02-04.
PMID: 35186749
Related Citations

Acceptability and Feasibility of Collecting Sexual Orientation and Expanded Gender Identity Data in Urology and Oncology Clinics.
Authors: Rosser B.R.S. , Polter E.J. , Chandiramani N. , Cahill S. , Wheldon C.W. , Konety B.R. , Ryan C.J. , Haggart R. , Kapoor A. .
Source: LGBT health, 2021 Aug-Sep; 8(6), p. 420-426.
EPub date: 2021-08-04.
PMID: 34348045
Related Citations

Every urologist and oncologist should know about treating sexual and gender minority prostate cancer patients: translating research findings into clinical practice.
Authors: Rosser B.R.S. , Rider G.N. , Kapoor A. , Talley K.M.C. , Haggart R. , Kohli N. , Konety B.R. , Mitteldorf D. , Polter E.J. , Ross M.W. , et al. .
Source: Translational andrology and urology, 2021 Jul; 10(7), p. 3208-3225.
PMID: 34430423
Related Citations

The Challenge of Coming Out to Providers by Gay and Bisexual Men With Prostate Cancer: Qualitative Results from the Restore Study.
Authors: West W. , Torres M.B. , Mitteldorf D. , Capistrant B.D. , Konety B.R. , Polter E. , Rosser B.R.S. .
Source: International journal of sexual health : official journal of the World Association for Sexual Health, 2021; 33(3), p. 426-438.
EPub date: 2021-08-13.
PMID: 36035335
Related Citations

The Reliability of Self-Reported Gleason Scores in Studies of Sexual Minority Prostate Cancer Survivors.
Authors: Rosser B.R.S. , Konety B.R. , Capistrant B.D. , Kapoor A. , Polter E. .
Source: Urology practice, 2020 May; 7(3), p. 224-227.
EPub date: 2020-05-01.
PMID: 34355044
Related Citations

The Influence of Companion Animals on Quality of Life of Gay and Bisexual Men Diagnosed with Prostate Cancer.
Authors: Wright M.M. , Schreiner P. , Rosser B.R.S. , Polter E.J. , Mitteldorf D. , West W. , Ross M.W. .
Source: International journal of environmental research and public health, 2019-11-13; 16(22), .
EPub date: 2019-11-13.
PMID: 31766206
Related Citations

Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer.
Authors: Capistrant B.D. , Lesher L. , Kohli N. , Merengwa E.N. , Konety B. , Mitteldorf D. , West W.G. , Rosser B.R.S. .
Source: Oncology nursing forum, 2018-07-02; 45(4), p. 439-455.
PMID: 29947351
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