scholarly journals Prostatectomy versus radiotherapy for early-stage prostate cancer (PREPaRE) study: protocol for a mixed-methods study of treatment decision-making in men with localised prostate cancer

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018403 ◽  
Author(s):  
Allan Ben Smith ◽  
Pascal Mancuso ◽  
Mark Sidhom ◽  
Karen Wong ◽  
Megan Berry ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Mixed Methods ◽  
Early Stage ◽  
Treatment Decision ◽  
Decisional Conflict ◽  
Robotic Prostatectomy ◽  
Mixed Methods Study ◽  
Curative Treatment ◽  
Treatment Decision Making

BackgroundMen diagnosed with localised prostate cancer (LPC) wanting curative treatment face a highly preference-sensitive choice between prostatectomy and radiotherapy, which offer similar cure rates but different side effects. This study aims to determine the information, decision-making needs and preferences of men with LPC choosing between robotic prostatectomy and standard external beam or stereotactic radiotherapy.Methods and analysisThis study will be conducted at a large public teaching hospital in Australia offering the choice between robotic prostatectomy and radiotherapy from early 2017. Men (20–30) diagnosed with LPC who want curative treatment and meet criteria for either treatment will be invited to participate. In this mixed-methods study, patients will complete semistructured interviews before and after attending a combined clinic in which they consult a urologist and a radiation oncologist regarding treatment and four questionnaires (one before treatment decision-making and three after) assessing demographic and clinical characteristics, involvement in decision-making, decisional conflict, satisfaction and regret. Combined clinic consultations will also be audio-recorded and clinicians will report their perceptions regarding patients’ suitability for, openness to and preferences for each treatment. Qualitative data will be transcribed verbatim and thematically analysed and descriptive statistical analyses will explore quantitative decision-making outcomes, with comparison according to treatment choice.DiscussionResults from this study will inform how to best support men diagnosed with LPC deciding which curative treatment option best suits their needs and may identify the need for and content required in a decision aid to support these men.Ethics and disseminationAll participants will provide written informed consent. Data will be rigorously managed in accordance with national legislation. Results will be disseminated via presentations to both scientific and layperson audiences and publications in peer-reviewed scientific journals.

Impact of a novel decision counseling program on treatment knowledge, decisional conflict, and choice in men with early-stage, low-risk prostate cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 9-9
Author(s):  
Jean H. Hoffman-Censits ◽  
Anett Petrich ◽  
Anna Quinn ◽  
Amy Leader ◽  
Leonard G. Gomella ◽  
...  
Keyword(s):  
Decision Making ◽  
Early Stage ◽  
Treatment Decision ◽  
Decisional Conflict ◽  
Counseling Program ◽  
Treatment Decision Making ◽  
Treatment Knowledge ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

9 Background: Active surveillance (AS - serial follow-up PSA, exam, and biopsy) is an option for men with early stage, low risk prostate cancer (LRPca). While data show comparable survival for AS vs active treatment (AT - surgery or radiation), currently most men with LRPca undergo AT. A pilot Decision Counseling Program (DCP) to assist men in making an informed, shared LRPca treatment decision was implemented. Methods: Men with LRPca seen at the Jefferson Genitourinary Multidisciplinary Cancer Center (JGUMDCC) were consented. A nurse educator (NE) reviewed risks/benefits of AS and AT; had the participant identify factors influencing treatment decision making and specify decision factor weights; entered data into an online DCP; and generated a report of participant treatment preference and decision factors. The report was used by the participant and clinicians in shared treatment decision making. A follow-up survey was administered 30 days after the visit, with treatment status assessed. Change in treatment-related knowledge and decisional conflict were measured using baseline and 30-day survey data. Results: Baseline decision counseling preference of 16 participants: 4 - AS, 8 equal for AS and AT, 4 - AT. At 30 days, 12 participants initiated AS, 4 chose AT; participant mean treatment knowledge scores (8-point scale) increased (+1.13 points); decisional conflict subscale scores (strongly disagree = 1, strongly agree = 5) decreased (uncertain: -1.15, uninformed: -1.36, unclear: -1.12; and unsupported: -1.15). Conclusions: Decision counseling and shared decision making helped participants become better informed about treatment choices and reduced uncertainty in treatment decision making. The combined intervention resulted in most participants choosing AS. Ongoing study recruitment, data collection, and analyses are planned.

scholarly journals Influence of Men’s Personality and Social Support on Treatment Decision-Making for Localized Prostate Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Elyse Reamer ◽  
Felix Yang ◽  
Margaret Holmes-Rovner ◽  
Joe Liu ◽  
Jinping Xu
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Treatment Decision ◽  
Population Based ◽  
Treatment Choice ◽  
Localized Prostate Cancer ◽  
Curative Treatment ◽  
Risk Level ◽  
Treatment Decision Making ◽  
Choice Decision

Background. Optimal treatment for localized prostate cancer (LPC) is controversial. We assessed the effects of personality, specialists seen, and involvement of spouse, family, or friends on treatment decision/decision-making qualities. Methods. We surveyed a population-based sample of men ≤ 75 years with newly diagnosed LPC about treatment choice, reasons for the choice, decision-making difficulty, satisfaction, and regret. Results. Of 160 men (71 black, 89 white), with a mean age of 61 (±7.3) years, 59% chose surgery, 31% chose radiation, and 10% chose active surveillance (AS)/watchful waiting (WW). Adjusting for age, race, comorbidity, tumor risk level, and treatment status, men who consulted friends during decision-making were more likely to choose curative treatment (radiation or surgery) than WW/AS (OR = 11.1, p<0.01; 8.7, p<0.01). Men who saw a radiation oncologist in addition to a urologist were more likely to choose radiation than surgery (OR = 6.0, p=0.04). Men who consulted family or friends (OR = 2.6, p<0.01; 3.7, p<0.01) experienced greater decision-making difficulty. No personality traits (pessimism, optimism, or faith) were associated with treatment choice/decision-making quality measures. Conclusions. In addition to specialist seen, consulting friends increased men’s likelihood of choosing curative treatment. Consulting family or friends increased decision-making difficulty.

Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial

2009 ◽  
Vol 77 (3) ◽  
pp. 349-359 ◽  
Author(s):  
Merle H. Mishel ◽  
Barbara B. Germino ◽  
Lin Lin ◽  
Raj S. Pruthi ◽  
Eric M. Wallen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trial ◽  
Decision Making ◽  
Randomized Clinical Trial ◽  
Early Stage ◽  
Treatment Decision ◽  
Treatment Decision Making
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