Supportive Care in Cancer

, Volume 19, Issue 9, pp 1411–1419 | Cite as

Exploring cancer support needs for older African-American men with prostate cancer

  • Randy A. JonesEmail author
  • Jennifer Wenzel
  • Ivora Hinton
  • Michael Cary
  • Naomi R. Jones
  • Sharon Krumm
  • Jean G. Ford
Original Article



The purpose of this study was to explore cancer support and financial issues related to cancer care experienced by African-American men with prostate cancer and to understand whom they relied on for resource issues during diagnosis and treatment.


This is a descriptive qualitative study of 23 rural and urban 65 years old and older African-American prostate cancer survivors. Five focus groups were conducted containing African-American prostate cancer survivors who were recruited from community-based centers (e.g., churches, barbershops, diners, and primary care clinics) in central Virginia and Maryland. Focus group discussions were audiotaped, transcribed, and coded. Data were organized and managed using a qualitative analysis software program. Emerging themes uncovered specific problems for older rural African-American men with cancer, and focus group data were examined for potential solutions to these problems.


Two common themes emerged: (1) family and physician support are important, and (2) insurance is a necessity for appropriate health care. A difference between rural and urban African-American prostate cancer survivors emerged as well: difference in spirituality during diagnosis and treatment.


Rural and urban African-American prostate cancer survivors' major support resource was their wives. Health insurance played a critical role as a support source by decreasing anxiety and financial hardships. Understanding rural and urban African-American prostate cancer survivors' support needs and challenges in relation to cancer diagnosis and treatment will allow nurses and other health-care providers to tailor cancer health plans more effectively for this population.


Prostate cancer survivors Support resource Support needs and challenges African-American Rural Urban 


  1. 1.
    American Cancer Society (2009) Cancer facts & figures 2009. Accessed 10 January 2010
  2. 2.
    Guidry J, Aday L, Zhang D, Winn R (1998) Cost considerations as potential barriers to cancer treatment. Cancer Pract 6(3):182–187PubMedCrossRefGoogle Scholar
  3. 3.
    Pearlin L (1989) The sociological study of stress. J Health Soc Behav 30:241–256PubMedCrossRefGoogle Scholar
  4. 4.
    Vrabec N (1995) Implications of U.S. health care reform for the rural elderly. Nurs Outlook 43(6):260–265PubMedCrossRefGoogle Scholar
  5. 5.
    Rogers C, Goldstein A, Cooley S (1993) Common beliefs about the rural elderly: what do the national data tell us? National center for health statistics. Vital Health 3(28):1–79Google Scholar
  6. 6.
    Mueller K (1997) Rural health care delivery and finance: policy and politics. In: Litman T, Robins L (eds) Health politics and policy, 3rd edn. Delmar, New York, pp 402–417Google Scholar
  7. 7.
    Weisgrau S (1997) Issues in rural health: access, hospitals, and reform. In: Harrington C, Estes C (eds) Health policy and nursing, 2nd edn. Jones & Bartlet, Boston, pp 71–78Google Scholar
  8. 8.
    Gornick M (2000) Vulnerable populations and medicare services. Century Foundation, New YorkGoogle Scholar
  9. 9.
    Farkas A, Marcella S, Rhoads GG (2000) Ethnic and racial differences in prostate cancer incidence and mortality. Ethn Dis 10(1):69–75PubMedGoogle Scholar
  10. 10.
    Agho AO, Lewis MA (2001) Correlates of actual and perceived knowledge of prostate cancer among African Americans. Cancer Nurs 24(3):165–171PubMedCrossRefGoogle Scholar
  11. 11.
    Kendall J, Hatton D (2002) Racism as a source of health disparity in families with children with attention deficit hyperactivity disorder. Adv Nurs Sci 25(2):22–39Google Scholar
  12. 12.
    Marks J (2002) Identifying the causes of health disparities. Chron Dis Notes Rep 15(2):2Google Scholar
  13. 13.
    Wolff M, Bates T, Beck B, Young S, Ahmed SM, Maurana C (2003) Cancer prevention in underserved African American communities: barriers and effective strategies—a review of the literature. WMJ 102(5):36–40PubMedGoogle Scholar
  14. 14.
    Goins R, Williams K, Carter M, Spencer M, Solovieva T (2005) Perceived barriers to health care access among rural older adults: a qualitative study. J Rural Health 21(3):206–213PubMedCrossRefGoogle Scholar
  15. 15.
    Berkman B, Sampson S (1993) Psychosocial effects of cancer economics on patients and their families. Cancer 72:2846–2889PubMedCrossRefGoogle Scholar
  16. 16.
    Chang S, Long S, Kutikova L, Bowman L, Finley D, Crown W (2004) Estimating the cost of cancer: results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000. J Clin Oncol 22(17):3524–3530PubMedCrossRefGoogle Scholar
  17. 17.
    Wagner L, Lacey M (2004) The hidden costs of cancer care: an overview with implications and referral resources for oncology nurses. Clin J Oncol Nurs 8(3):279–287PubMedCrossRefGoogle Scholar
  18. 18.
    Sussman L, Robins L, Earls F (1987) Treatment-seeking for depression by black and white Americans. Soc Sci Med 24(3):187–196PubMedCrossRefGoogle Scholar
  19. 19.
    Neighbors H, Jackson J (1984) The use of informal and formal help: four patterns of illness behavior in the black community. Am J Community Psychol 12(6):629–644PubMedCrossRefGoogle Scholar
  20. 20.
    Callaghan P, Morrisey J (1993) Social support and health: a review. J Adv Nurs 18:203–210PubMedCrossRefGoogle Scholar
  21. 21.
    Wheaton B (1985) Models for the stress-buffering functions of coping responses. J Health Soc Behav 26:352–364PubMedCrossRefGoogle Scholar
  22. 22.
    Jones R, Steeves R, Williams I (2010) Family and friend interactions among African American men deciding whether to have a prostate cancer screening. Urol Nurs 30(3):189–194PubMedGoogle Scholar
  23. 23.
    Lee C, Owens R (2002) Issues for a psychology of men's health. J Health Psychol 7(3):209–217CrossRefGoogle Scholar
  24. 24.
    Cohen M, Kahn D, Steeves R (2000) Hermeneutic phenomenological research: a practical guide for nurse researchers. Sage, Thousand OaksGoogle Scholar
  25. 25.
    Steeves R, Kahn D, Cohen M (1996) Asking substantive theory questions of naturalistically derived data. West J Nurs Res 18(2):209–212PubMedCrossRefGoogle Scholar
  26. 26.
    Aronson J (1994) A pragmatic view of thematic analysis. Qual Rep 1:1–3Google Scholar
  27. 27.
    Lincoln Y, Guba E (1985) Naturalistic inquiry. Sage, LondonGoogle Scholar
  28. 28.
    Kockelmans J (1965) Martin Heidegger. Duquesne University Press, PittsburghGoogle Scholar
  29. 29.
    Sandelowski M (1993) Rigor or rigor mortis: the problem of rigor in qualitative research revisited. Adv Nurs Sci 16(2):1–8Google Scholar
  30. 30.
    Rodgers B, Cowles K (1993) The qualitative research audit trail: a complex collection of documentation. Res Nurs Health 16:219–226PubMedCrossRefGoogle Scholar
  31. 31.
    Clemen-Stone S, McGuire S, Eigsti D (2002) Comprehensive community health nursing: family, aggregate & community practice. Mosby, St. LouisGoogle Scholar
  32. 32.
    Coleman M, Ganong L, Clark J, Madsen R (1989) Parenting perceptions in rural and urban families: is there a difference? J Marriage Fam 51:329–335CrossRefGoogle Scholar
  33. 33.
    Whitlatch C (2008) Informal caregivers: communication and decision making. Am J Nurs 108(9):73–77PubMedCrossRefGoogle Scholar
  34. 34.
    Mellon S, Berry-Bobovski L, Gold R, Levin N, Tainsky M (2006) Communication and decision-making about seeking inherited cancer risk information: findings from female survivor-relative focus groups. Psycho-Oncol 15:193–208CrossRefGoogle Scholar
  35. 35.
    Addis M, Mahalik J (2003) Men, masculinity, and the contexts of help seeking. Am Psychol 58(1):5–14PubMedCrossRefGoogle Scholar
  36. 36.
    Smedley B, Stith A, Nelson A (eds) (2002) Unequal treatment: confronting racial and ethnic disparities in health care. The National Academies Press, Washington, DCGoogle Scholar
  37. 37.
    Board on Health Care Services (2008) Cancer care for the whole patient: meeting psychosocial health needs. The National Academies Press, Washington, DCGoogle Scholar
  38. 38.
    Hadley J (2003) Sicker and poorer: the consequences of being uninsured. Med Care Res Rev 60(2, suppl):3S–75SPubMedCrossRefGoogle Scholar
  39. 39.
    Banks I (2001) No man's land: men, illness, and the NHS. BMJ 323(7320):1058–1060PubMedCrossRefGoogle Scholar
  40. 40.
    Kroenke C, Kubzansky L, Schernhammer E, Holmes M, Kawach I (2006) Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncol 24(7):1105–1111PubMedCrossRefGoogle Scholar
  41. 41.
    Antoni M, Lutgendorf S (2007) Psychosocial factors and disease progression in cancer. Curr Dir Psychol Sci 16(1):42–46CrossRefGoogle Scholar
  42. 42.
    Bayliss E, Steiner J, Fernald D, Crane L, Main D (2003) Description of barriers to self-care by persons with comorbid chronic diseases. Ann Fam Med 1(1):15–21PubMedCrossRefGoogle Scholar
  43. 43.
    Jerant A, von Friederichs-Fitzwater M, Moore M (2005) Patients' perceived barriers to active self-management of chronic conditions. Patient Educ Couns 57(1):300–307PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Randy A. Jones
    • 1
  • Jennifer Wenzel
    • 2
  • Ivora Hinton
    • 1
  • Michael Cary
    • 1
  • Naomi R. Jones
    • 1
  • Sharon Krumm
    • 2
  • Jean G. Ford
    • 2
  1. 1.University of VirginiaCharlottesvilleUSA
  2. 2.Johns Hopkins UniversityBaltimoreUSA

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