by Meng Chunling. / "September 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 143-159). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Xu, Dandan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 209-231). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

We sought increased understanding of men's decision-making process for prostate-specific antigen (PSA) screening, especially among elderly men, and a more knowledgeable basis for interventions to modify screening rates. A cross-sectional postal questionnaire assessed measures consistent with the Theory of Planned Behavior among a population-based age-stratified random sample of 452 Iowa men who were free of prostate cancer and aware of PSA. Our primary outcome was intention to receive PSA screening within a year; this encompassed the degree men wanted and planned to be screened. We examined three explanatory variables via structural equation modeling: attitude, social influence, and perceived control. Attitude included the degree screening is important-unnecessary, reassuring-worrisome, and useful-useless. Social influence encompassed the extent a man believed people expect him to, and think he should be screened. Perceived control covered the degree a man can be screened, if desired, and how much control he has over screening. We then examined attitude, social influence, and perceived control as dependent variables. We examined how potential outcomes of screening influenced attitude, how specific people affected overall social influence, and how specific factors influenced perceived control. Roughly 75% expressed intent to receive PSA screening within a year. Attitude, social influence, and perceived control each contributed significantly to the explanation of intentions (p<0.001); the model accounted for 72% of the variability in intention. Detecting cancer early, obtaining peace of mind, knowing their PSA value, and false test results were potential outcomes and each convincingly influenced attitude. A man's wife, primary care physician, urologist, family, friends, and people with cancer each visibly swayed overall perceived social influence. The impacts of health insurance, transportation, information, health problems, including PSA in routine exams, and primary care physicians on perceived control was less clear. Elderly men were unaware of the PSA controversy and believed physicians recommend screening men their age. Our results suggest potential strategies to modify screening rates that include messages to modify men's attitudes about PSA screening and messages that target socially influential people. Being uninformed appears to be an important problem among elderly men who receive PSA screening.

These short stories deal with young boys and men who raise themselves in the absence of proper parenting. In particular, they wrestle with big questions about the family unit, sex, and love.

The aim of this thesis is to describe how men with localised prostate cancer make decisions about their medical treatments, to describe the psychological and decision-related adjustment of these men over time, and to identify what variables predict decision-related adjustment. Chapter 1 reviews the medical context of localised prostate cancer and factors that influence men's decision making in this context. It is concluded that owing to ongoing uncertainty about the optimal medical treatment for this cancer and the substantial negative quality of life effects of treatments, how men make decisions in this context is an important research question. Further, although men with prostate cancer are high seekers of medical treatment information, knowledge about how men use such information and actually make this treatment decision is limited. Chapter 2 discusses research approaches currently applied to patient decision making: first, a social interaction approach encompassing the interaction between the patient and their physician and the social context influencing this interaction (Charles, Gafni, & Whelan, 1999); and second, normative decision theory (Shafir & Tversky, 1992; von Neumann & Morgenstern, 1947). The Heuristic-Systematic Processing model (Chaiken, 1980) is then proposed as a theoretical framework for investigating patient decision making that includes both systematic and non-systematic decision strategies. Chapter 3 reviews applied decision research in cancer, and presents an overview of research findings regarding patients' preferences for involvement in decision making, the relationship between decisional involvement and psychological adjustment, and decisional support interventions. Research on adjustment to cancer is discussed and the need for further research about men's psychological and decision-related adjustment after localised prostate cancer is identified. Finally, a multivariate analysis of decision-related adjustment for men with localised prostate cancer based on the stress and coping framework of Lazarus and Folkman (1984) is proposed. Chapter 4 describes Study 1 that was an experiment to investigate the utility of the Heuristic-Systematic Processing model (HSM) in explaining low desire for involvement in decision making about prostate cancer treatments as an example of use of the expert opinion heuristic. Using a hypothetical decision scenario about localised prostate cancer it was found that a low desire for involvement in decision making by men was predicted by a high belief in powerful others controlling health, a low belief in the self being responsible for good health, a high preference for black and white thinking, and a lower level of education. This study provides preliminary support for use of the HSM in this context and for the conceptualisation of decision deferral as the expert opinion heuristic. Chapter 5 introduces and describes the method of Study 2 that was a descriptive, prospective study of men's decision making after an actual diagnosis of localised prostate cancer. This method allowed for an analysis of men's decision making that includes both systematic and non-systematic processes, and for further investigation of the utility of the HSM in explaining decision behaviour. In addition, a multivariate approach was used to describe men's physical, psychological and decision-related adjustment over time, and to identify psychological predictors of decision-related adjustment. Chapters 6 describes men's use of systematic processing as limited and the use of non-systematic processes, such as lay beliefs and heuristics, as pervasive. It is concluded that patients do not utilise information about medical treatments in a comprehensive or systematic way when making treatment decisions and that patients' decision making is biased by their prior beliefs about cancer and health. A framework is outlined to demonstrate how the results of Study 1 and 2 support the application of the HSM to decision making about prostate cancer with particular reference to the role of beliefs about the physician, health locus of control, and uncertainty about the treatment decision in influencing decision strategies. Chapter 7 describes men's physical, psychological and decision-related adjustment over time, and concludes that decision-related distress is high but psychological distress in general is low. Decisional conflict at diagnosis and at twelve months concurrently, and at two months prospectively, was predicted by dispositional optimism; and this effect was mediated by the man's proximal cognitive appraisal of the impact of the cancer. It is concluded that decisional conflict is a person's cognitive judgment of the treatment decision that is generated by similar processes to that of the psychological distress that follows a cancer diagnosis. Conclusions and implications of these studies for future research in this area are summarised in Chapter 8.

Prostate cancer is one of the most prominent diseases in men’s health. It is inherently 'male', given the exclusivity of the prostate gland to men’s bodies and its physiological connection to testosterone and male sexuality. The biomedical complexities of prostate cancer continue to be unravelled and researched and are often connected to identifying causes, the virtues of screening and treatment modalities. However, despite the biological male 'sex' link, most of the prostate cancer research is not connected with research on gender relations, men and masculinities. The net outcome is that men’s lives and illness experiences are absent in much of the prostate cancer research. This PhD thesis Prostate cancer: Anglo-Australian heterosexual perspectives, is an ethnographic study of thirty-five Anglo-Australian men diagnosed with prostate cancer. Participants shared their experiences of living with prostate cancer in the context of health promotion, health services and in relation to their sexuality and intimate relationships. Through participant photographic novella and in-depth semi-structured interviews, rich cultural insights are provided. A social constructionist gender analysis is used in this research that shows how the social constructions of masculinity interconnect and occasionally collide with prostate cancer throughout the illness trajectory.

Active Surveillance (AS) for the clinical management of prostate cancer (PC) is a treatment option for men with low-risk PC. Screening procedures have led to the overdetection of PCs that would have never caused problems. Active treatment (e.g., surgery or radiation) for these non-aggressive tumors may not be necessary given the slow-growing nature of PC. AS provides a way to monitor the disease and delay treatment-related compromises on quality of life until clinically indicated (e.g., rising PSA level). However, the intensive monitoring in AS may be a stressful experience and lead to greater anxiety, an emotional state that has been associated with undergoing active treatment despite physician recommendation for AS. The current study aimed to identify psychosocial correlates of anxiety in men undergoing AS. Using Mishel’s Reconceptualized Uncertainty in Illness Model as a framework, the proposed study aimed to examine the relationships between perceived stress management skills, PC psychosocial concerns, and anxiety/arousal. Hierarchical multiple regression analyses were conducted on a sample of 71 men undergoing AS, who were on average 65.40 years old (SD=7.85) and ethnically diverse (52% non-Hispanic White; 31% Hispanic; 17% African American). Results indicated that greater PSMS were significantly associated with less IES-R anxiety (β=-.28, p<.04). PSMS were not significantly associated with PC concerns (β=-.02, p>.05), but greater PC concerns were significantly associated with greater IES-R anxiety (β=.61, p<.01) and PSA anxiety (β=.42, p<.01). These associations held after controlling for relevant covariates. The results suggest a possible role for stress management skills as perceived ability to manage stress was related to less anxiety in the AS experience. Future studies should examine the relationship among these factors in longitudinal designs and whether greater stress is associated with unnecessary active treatment in low-risk PC.

Using the computer code Monte Carlo N-Particle (MCNP), doses were calculated for organs of interest such as the large intestine, urinary bladder, testes, and kidneys while patients were undergoing prostate brachytherapy. This research is important because the doses delivered to the prostate are extremely high and the organs near the prostate are potentially at risk for receiving high doses of radiation, leading to increased probabilities of adverse health effects such as cancer. In this research, two MCNP version 4C codes were used to calculate the imparted energies to the organs of interest delivered by 125I and 103Pd. As expected, the organs nearest to the prostate received the highest energy depositions and the organs farthest from the prostate received the lowest energy depositions. Once the energy depositions were calculated, the doses to the organs were calculated using the known volumes and densities of the organs. Finally, the doses to the organs over an infinite time period were calculated.

Prostate cancer is one of the most malignant tumors in the world. It has been demonstrated that prostate cancer could metastasis to bones, bladder, rectum, and lymph nodes. It is the most common type of cancer found in adult males, and the mortality is elevated. From screening our chemical library of 398 small molecule compounds, we have found that TCH derivatives showed anti-proliferative activities using prostate cancer cell line PC-3. The results of MTT assay allow us to identify TCH-1038w as potential candidat for developing anticancer drug. Morphological investigation on PC-3 cells after TCH-1038w treatment showed that PC-3 cells rounded up and combined with cell shrinkage, abridge, membrane blebbing. Our results of flowcytometric analysis showed that TCH-1038w can cause the percentage increase of sub-G1 that indicated the DNA fragmention in TCH treated PC-3 cells. By DAPI staining , we observed that TCH-1038w can induce the DNA fragmentation in PC-3 cells. Moreover by immunoblotting analysis, we have demonstrated that procaspase 3 and PARP were cleavaged and activated after TCH treatment. These results indicsted TCH drugs can induce caspase activation, DNA fragmentation, and consequently cause apoptotic cell death. Together, TCH-1038w may serve as a potential chemotherapy candidate for treating prosate cancer in the future.

ABSTRACT THE RELATIONSHIP BETWEEN UNMETABOLIZED FOLIC ACID AND SERUM FOLATE CONCENTRATIONS AND CANCER RISK IN OLDER US ADULTS by Regine L. Baldauff Importance Several studies have reported an increase in serum and unmetabolized folic acid levels since the implementation of folic acid fortification (January 1, 1998). However, the literature published during the post-folic acid fortification period is controversial with regards to the safety and potential risk for cancer in non-target populations. Objective To study the association between unmetabolized folic acid and serum folate and cancer in older US adults. Design, Setting, and Participants This is a cross sectional study using data from National Health and Nutrition Examination Surveys. Among 700 participants with identified unmetabolized folic acid, 147 cases were reported a history of having cancer from 1999-2002. Within the 7,981 subjects who had a recorded value for serum folate from 1999-2008; 1,459 reported a history of all cancer. Among the 4,007 women who had a recorded value for serum folate between 1999-2008; 288 reported a history of breast cancer. Main Outcome Measures Associations of unmetabolized folic acid and serum folate with all cancer and breast cancer was evaluated using a multivariable logistic regression analysis controlling for demographic and dietary intakes. Results Men and women without unmetabolized folic acid were 0.7 times less likely to develop cancer. Those over the age of sixty with the highest concentration of serum folate were 1.4 times more likely to have cancer than participants with lower serum folate concentrations. Women over the age of sixty with the highest concentration of serum folate were 1.8 times more likely to have breast cancer compared to women with lower serum folate concentrations. Conclusions and Relevance The presence of unmetabolized folic acid and high serum folate concentrations were related to an increased prevalence of cancer. Further research is warranted to investigate the cause and effect relationship.