TESTIS CANCER SURVIVORS' ADJUSTMENT AND HEALTH BEHAVIOR
Basen-Engquist, Karen M
5R03CA083348-2
The ultimate aims of this research are to ascertain whether cancer exacts a long-term or continuing economic toll from survivors and their families and, if it does, to identify key factors that either raise or lower that toll in order to facilitate the design of cost-minimizing interventions. A small scale study focusing on female breast cancer survivors is proposed here as a first step in this research effort. The study sample will be comprised of approximately 100 women who were treated for breast cancer at a single center at some point prior to 1993 and another 100 women matched on age and labor market status at the same point in time who have never had malignant disease. A face-to-face interview will be conducted with each case and control subject to obtain information needed to estimate the "indirect morbidity costs" of breast cancer. This information includes retrospective work histories over the previous five or more years to test whether there are significant differences between cases and controls in work effort or labor market attachment, profiles of market earnings and job-related benefits to test whether there is evidence of discrimination against cancer survivors, and retrospective work histories of household members to ascertain whether breast cancer affects the earnings and wealth position of those household members as well. Survey data will be used to estimate the dollar value of these economic losses. Univariate and multivariate statistical analyses will then be conducted to assess whether the magnitude of the losses differs significantly between cases and controls. Implications of the empirical findings for designing and evaluating cancer control interventions will be discussed in some detail. The incidence of testis cancer is increasing worldwide. Although testis cancer represents only about 1 percent of all male incident cancer, it is the most common neoplasm in men between the ages of 15 and 44. Because of the young age at diagnosis and the very high success rate in testis cancer treatment, survivorship issues become tremendously important. To date there are only a few studies examining quality of life, health behaviors, and overall adjustment in testis cancer survivors. The proposed study will compare quality of life and health behaviors of testicular cancer survivors to those of family controls. We will sample 256 2- to 7- year survivors of testis cancer who have been treated at the University of Texas M. D. Anderson Cancer Center, and interview them regarding their quality of life and health behaviors. Each survivor also will be asked to identify a brother of similar age (with other relatives used if no brother is available) who will be interviewed to serve as a control. We will assess quality of life, mental health, sexual and functioning, and relationship satisfaction. A unique feature of this study is that we will assess comfort with dating and intimate relationships for unpartnered survivors, as well as assessing marital functioning for men who are with a partner. Additionally, this study will examine the direct and indirect effects of psychosocial variables and health behaviors as predictors of quality of life. Determination of factors that are associated with better adjustment will help tailor interventions to reduce the stress of life-threatening diseases. Furthermore, identification of protective and risk factors will help target individuals at greater risk for medical complications and adjustment problems.
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