During the month of November, the world witnesses an influx of people growing mustaches. This annual phenomenon, known as Movember, aims to “change the face of men’s health” and is done to raise awareness about men’s health issues such as prostate cancer, testicular cancer and mental health and suicide prevention. Using the mustache as the driving symbol of the movement, Movember aims to increase early mental health and cancer detection; spur diagnosis and the development of effective treatments; and ultimately reduce the number of preventable deaths.
The Patient-Centered Outcomes Research Institute (PCORI) is an independent, nonprofit research organization seeking to empower patients and others with actionable information about their health and healthcare choices. PCORI does this by funding comparative clinical effectiveness research (CER), which compares two or more medical treatments, services or health practices to help individuals make better informed decisions. Additionally, PCORI funds efforts to promote engagement in research and projects to implement CER into clinical practice, and releases funding announcements several times per year.
Research funded by PCORI includes several health issues highlighted through the Movember campaign including prostate cancer, mental health, suicide prevention and other men’s health conditions.
Here’s a snapshot of PCORI’s work impacting men’s health.
Prostate cancer is one of the most diagnosed cancers in men in the United States; however, it is also one of the most curable cancers when caught early. One in eight men are expected to be diagnosed with prostate cancer in their lifetime, with the risk increasing for men with a family history of prostate cancer, as well as African American men, who are prone to developing forms of the disease that may require a more aggressive treatment approach.
Below are several PCORI-funded studies and projects comparing various diagnostic and treatment options. We encourage you to learn more about the impact being made within the prostate cancer community.
PCORI-Funded Completed Projects
- Men treated for prostate cancer undergo prostate-specific antigen, or PSA, blood tests as part of their follow-up care to monitor for, and detect, recurrence. However, the optimal frequency of a PSA test posttreatment in men with early-stage prostate cancer is unknown and may depend on a patient’s chance for recurrence, as well as their primary treatment choice.
Researchers in North Carolina completed two studies to better understand the benefits and harms of different posttreatment PSA surveillance frequencies, as well as the potential effects the frequency of these posttreatment PSA tests had on a patient’s outcome, including their quality of life and anxiety level. Results from both studies showed little to no difference in such areas as survival rates or quality of life, to name a few. Read results.
- Early-stage prostate cancer can be treated in different ways. Three of the most common ways include active surveillance, surgery and radiotherapy. Two PCORI-funded studies comparing the effects of these choices on the quality of life for men with localized prostate cancer—including such side effects as problems having sex, urinary problems and bowel problems—were carried out across the United States. Research showed the different ways of treating early-stage prostate cancer affect men differently. Men who had surgery or radiotherapy had more sexual, urinary and bowel problems in the first year compared with men who were treated with active surveillance. After two to three years, most symptoms improved, but there may still be lasting differences among these treatment groups.
Results from this work also became the basis of an Evidence Update and the development of patient education materials the American Urological Association, ASTRO, Men’s Health Network and Urology Care Foundation co-branded and shared throughout the prostate cancer community, as well as the broader patient, caregiver and medical community. Read the results from each study: CEASAR Study and NC ProCESS.
PCORI-Funded Projects Underway
- A project underway in California and Tennessee aims to put into practice a treatment decision aid for men with early-stage prostate cancer. This decision aid has been recently updated to reflect results from an earlier PCORI-funded study in which patients self-reported how effective and satisfactory surgery, external beam radiation or active surveillance were for them. This insight offers men a tool they can complete and review with their physician prior to determine a prostate cancer treatment strategy. Learn more.
- Working with cancer clinics from around the country, researchers are seeking to compare photon and proton therapy, to better understand how each treatment affects patients’ quality of life, side effects, and risk of prostate cancer coming back.The team is also studying two different doses of proton therapy to see if shorter, higher dose treatment is as safe and effective as longer, lower dose treatment. Learn more.
- Men with prostate cancer have many treatment options, including several newer approaches. A study underway in California and New York aims to compare the quality of life and other health outcomes of men who chose one of the following five prostate cancer treatment approaches:
- Radical prostatectomy, or surgery to remove the prostate gland
- Partial gland ablation, which uses heat or cold to kill cancer cells in the prostate
- Intensity-modulated radiation therapy, which uses beams of radiation to kill cancer cells in the prostate
- Stereotactic body radiation therapy, which uses strong, focused doses of radiation to kill cancer cells in the prostate and limits damage to healthy tissue
- Active surveillance, where the doctor checks the patient every few months to make sure the cancer isn’t getting worse
Results may help men with prostate cancer and their doctors when considering treatment options Learn more.
Mental Health and Suicide Prevention
Mental illness impacts millions of people in the US each year. Nearly one in 10 men experience some form of depression or anxiety, but fewer than half seek treatment. Unfortunately, men are also at high risk for suicide and account for nearly 80 percent of people who commit suicide. Male veterans are also particularly vulnerable to mental health disorders, including post-traumatic stress disorder (PTSD), linked to suicide.
The following PCORI-funded research and projects aim to help shed light on mental health conditions and the critical need for suicide prevention.
PCORI-Funded Completed Projects
- Lack of social support and social isolation are known risk factors for veteran suicide. A recent engagement project in Texas gathered 200 stakeholders, including veterans, their significant others, mental health providers and researchers, to develop strategies to enhance veteran suicide prevention research. Through this project, a multistakeholder advisory panel was developed and tools for leveraging social connectedness to reduce suicide among veterans were identified. Learn more.
- Living in a rural area is also a risk factor for suicide. An engagement project brought together community stakeholders to share evidence-based practices for suicide prevention in rural and western Colorado. The stakeholders also collaborated to develop a research agenda to inform future research. Learn more.
PCORI-Funded Projects Underway
- Chronic medical illness is associated with the development of depression in older adults. An engagement project in Chicago is currently establishing an advisory committee of patients, caregivers, advocates, clinicians and researchers to help develop care models to support older adults with depression and medical comorbidities. The project aims to foster stakeholder collaboration and develop ideas for future CER studies on depression among older adults. Learn more.
- Researchers in Pennsylvania are currently enrolling veterans into a study to compare three different ways to treat PTSD. PTSD leads to a chronic, heightened sense of fear and danger, even when people are physically safe. Veterans are being selected by chance to receive medication, prolonged exposure therapy to help confront their fears and trauma, or both medicine and prolonged exposure therapy to treat PTSD. Anticipated study completion is in 2026. Learn more.
To learn more about PTSD, we encourage you to explore our systematic review on the management of PTSD. This systematic review, Psychological and Pharmacological Treatments for Adults with Post-Traumatic Stress Disorder, is an update a report published in 2013 that evaluated psychological and pharmacological treatments of adults with PTSD. The review focuses on updating the earlier work, expanding the range of treatments examined, addressing earlier uncertainties, identifying ways to improve care for PTSD patients and reducing variation in existing treatment guidelines. This review provided background for both a targeted PCORI research funding announcement, as well as a PCORI Dissemination and Implementation project.
For more information, visit www.PCORI.org.
William Lawrence, MD, MS is the Senior Clinical Advisor, Office of the Chief Engagement and Dissemination Officer, at the Patient-Centered Outcomes Research Institute (PCORI).