Religion can be an important resource for people struggling with chronic illness. Problem-solving skills have also been shown to be helpful. This study examined whether turning to religion as a coping resource would be associated with better problem-solving in couples trying to manage challenges associated with prostate cancer. The sample was 101 patients with prostate cancer and their wives. Wives completed the Social Problem-Solving Inventory--Revised at baseline (T1) and 10 weeks later (T2). Patients and their wives also completed a measure that included items on religious coping. These items were used to classify couples into four groups based on whether one or both members engaged in religious coping: (1) husband only, (2) wife only, (3) both husband and wife, and (4) neither husband nor wife. From T1 to T2, wives who used religious coping along with their husbands (group 3) showed a significantly greater reduction in dysfunctional problem-solving (specifically, on impulsive/careless problem-solving) in comparison with wives who used religious coping while their husbands did not (group 2). Findings suggest that when couples share in turning to religion as a source of coping, this may be associated with improved problem-solving, but sole engagement in religious coping by wives may be associated with worse problem-solving.

Isolated mediastinal masses are an uncommon manifestation of prostate cancer metastasis. Here we report a unique presentation of a patient with prostate adenocarcinoma who presented with massive mediastinal adenopathy with aggressive tracheal invasion. CASE PRESENTATION:A 73 year old male with a history of prostate cancer was transferred for progressive dyspnea and radiographic airway narrowing. On physical exam the patient was in mild distress with phonation. He had course lung sounds in the upper lobes, diminished in the lower lobes, without stridor or wheezing. A computed tomography of the chest revealed a bulky right paratracheal mass that laterally invaded of the right side of the trachea. This caused approximately 50% occlusion of the tracheal lumen. The mass measured 7.6 cm AP, 7.9 cm transverse and 7.8 cm craniocaudal. CT demonstrated no parenchymal abnormalities or pulmonary nodules. Given the isolated lymphadenopathy, it was thought that this presentation was related to a separate primary lung malignancy over a metastatic focus of disease. The patient subsequently underwent debulking via rigid bronchoscopy. Pathology confirmed a diagnosis of metastatic prostatic adenocarcinoma with high-grade neuroendocrine carcinoma features.