Results of a cross-sectional survey to explore determinants of health-promoting activities among Hispanic/Latino (H/L) patients (pts) with prostate cancer (PCa) on androgen deprivation therapy (ADT).
Authors: Sharon H. Choi, Frances Ramos Diaz, Kristine Ly, Yu-Wei Chen, James Michael Randall, Tyler F. Stewart, Fred Millard, James Murphy, Noe Crespo, Soo J Park, Brent S Rose, Aditya Bagrodia, Elena Martinez, Rana R. McKay
Journal: Journal of Clinical Oncology (2025)

321 Background: H/L pts with PCa are at an increased risk of developing ADT-related side effects. Diet and exercise can improve PCa-related outcomes, including reducing ADT-related toxicities. However, little is known about individual perspectives on factors impacting engagement in health-promoting behaviors among H/L men with PCa. Methods: We developed a survey to examine sociodemographic characteristics, exercise/dietary habits, motivation for change, and barriers to participate in lifestyle interventions. We surveyed pts with PCa who self-identified as H/L ethnicity, treated at UCSD, and who were either previously or currently on ADT at the time of the survey. Questionnaires were administered in Spanish or English, either in person or by telephone, using interpreter services based on pt preference. Results: Between April and August 2024, 61 pts (median age 66 years) completed the survey with an 88% response rate. Most pts were of Mexican descent (85%), born outside the U.S. (72%), had public health insurance (51%), resided in disadvantaged neighborhoods (54%) based on the Area Deprivation Index, from H/L ethnic enclaves (64%), and were primarily Spanish speakers (51%), with 36% reporting no English proficiency. About half (49%) reported household financial distress, yet 92% felt supported by their community or family during PCa diagnosis. At the time of the survey, 85% of pts were on ADT, 68% had distant metastasis, and 69% had undergone local therapy. Most had a BMI ≥ 30 kg/m2 (52%), diabetes (51%), and 66% had a history of coronary artery disease or a high-risk atherosclerotic cardiovascular disease score of ≥ 20%. Most pts (51%) reported limited dietary monitoring and 71% reported less than 50 min/week of moderate-intensity exercise, with 41% not engaging in any moderate exercise. However, most expressed motivation to initiate lifestyle changes (91% exercise; 83% diet) and 82% showed interest in joining a community lifestyle intervention program. Pts identified participation incentives including family involvement (73%), other H/L participants (77%), Spanish-speaking staff (86% among Spanish speakers), and a driving distance of less than 5 miles. Conclusions: We report that H/L pts with PCa on ADT have substantial cardiometabolic risk factors. While engagement in health-promoting activities was limited, patients expressed motivation to improve health-promoting practices, with actionable incentives to enhance participation, underscoring the need for tailored intervention to mitigate ADT toxicity in this pt population. These findings will inform the design of an interventional study that examines the impact of a combined group exercise and nutrition counseling intervention on physical fitness and cardiovascular health among H/L men with PCa on ADT.