Caballero, Amanda

Abstract Black/African American populations, globally, bear the greatest prostate cancer (CaP) burden compared to other racial/ethnic groups. Addressing CaP disparities in Black men is complex, requiring a patient-centered, community-centric and comprehensive approach. This study integrates iCCaRE Consortium findings and broader literature to address unmet needs in survivorship care. The iCCaRE Consortium implemented five complementary pilot studies using mixed-methods designs, including feasibility trials, qualitative research, and observational analyses across the United States and sub-Saharan Africa. Descriptive statistics, subgroup analyses, and qualitative thematic analyses were performed across these studies. Collectively, projects addressed multilevel determinants including social, behavioral, and biological drivers of disparities. Project 1 implemented a Virtual Reality Assistant (ViRA) across clinical and community settings, with ongoing evaluation in pragmatic trials. Project 2 showed strong patient preference for home-based cancer care. Project 3 enrolled demonstrated trends toward improved health-related quality of life. Project 4 identified key themes influencing survivorship experiences. Project 5 identified biological mechanisms linking stress, immune modulation, and symptom burden. The iCCaRE pilot projects demonstrate the feasibility and early impact of a consortium-based, transdisciplinary approach to addressing CaP disparities in Black men. These findings highlight the importance of integrating patient-centered interventions, community engagement, and biological insights to inform scalable strategies aimed at improving survivorship outcomes and advancing health equity. The iCCaRE Consortium demonstrates that a transatlantic, patient-centered, and multidisciplinary approach integrating social, clinical, and biological factors can generate scalable strategies to improve survivorship outcomes and advance equity in CaP care for Black men.

Prostate cancer is a growing public health concern in Kenya, where it is frequently diagnosed at advanced stages and managed within resource-constrained health systems. This study examined the lived experiences of men diagnosed with prostate cancer, focusing on how the illness shaped their identities, relationships, and daily lives. We conducted a qualitative study using in-depth interviews with 130 men recruited from oncology clinics across five counties (Nairobi, Garissa, Meru, Machakos, and Kisii). Audio recordings were transcribed and translated verbatim into English, where necessary, by trained research assistants. Thematic analysis was conducted following the Braun and Clarke’s six-phase framework, with NVivo 12 Plus supporting data management. Five core themes emerged: 1) emotional and existential disruption at diagnosis; (2) treatment as both a source of hope and hardship; (3) geographic and financial barriers to care; (4) challenges to masculine identity and dignity; and (5) the dual role of family and community as sources of both support and stigma. Prostate cancer precipitated profound identity shifts for Kenyan men, transforming lived experiences from those of strong providers to vulnerable patients and disrupting deeply rooted social and personal roles. These findings underscore the need for holistic, culturally responsive cancer care that integrates psychosocial support from the point of diagnosis and addresses structural barriers to access. Such approaches are essential for advancing patient-centered prostate cancer care in Kenya and similar settings.