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

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.

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Treatment decision-making in men with localized prostate cancer living in remote area: A cross-sectional observational study

Canadian Urological Association Journal ◽

10.5489/cuaj.6521 ◽

2020 ◽

Vol 15 (3) ◽

Author(s):

Abir El-Haouly ◽

Alice Dragomir ◽

Hares El-Rami ◽

Frédéric Liandier ◽

Anaïs Lacasse

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Multiple Logistic Regression Analysis ◽

Treatment Decision ◽

Treatment Choice ◽

Localized Prostate Cancer ◽

Cancer Stage ◽

Cross Sectional ◽

Remote Areas ◽

Treatment Decision Making

Introduction: For the management of localized prostate cancer, patient treatment choice is poorly documented among people living in remote areas where access to certain treatments offered in large centres involves travelling several hundred kilometres. This study aimed to describe and identify the determinants of treatment decision-making in men with localized prostate cancer living in remote areas. Methods: In this cross-sectional study, patients with prostate cancer were recruited from Rouyn-Noranda’s urology clinic (Quebec, Canada) between 2017 and 2019. Results: A total of 127 men (mean age 68.34±7.23 years) constituted the study sample. Radiotherapy, a treatment not available locally, was chosen most frequently (67.7%), followed by options available locally, such as surgery (22.8%) and active surveillance (9.4%). Most patients preferred to play an active role in this choice (53.5%) and agreed with the statement, “I chose that treatment because it gives the best chance for a cure” (86.6%). Multiple logistic regression analysis revealed that cancer stage (odds ratio [OR] 10.15; 95% confidence interval [CI] 3.18–32.40) was the only factor associated with radiotherapy choice (patients with lower stage cancer were more likely to choose radiotherapy). The socioeconomic status was not associated with treatment choice. Conclusions: While radiotherapy was not available locally, it was the most frequently chosen treatment, even though the available literature suggests that no one treatment option is superior in terms of cancer control. The choice of radiotherapy is not associated with patient income, but rather the cancer stage. This result could be explained by the patients’ desire to avoid surgery and its adverse effects.

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Abstract A48: Treatment decision making in a population-based sample of black and white men with localized prostate cancer

10.1158/1538-7755.disp15-a48 ◽

2016 ◽

Author(s):

Elyse Reamer ◽

Felix Yang ◽

Jinping Xu

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Treatment Decision ◽

White Men ◽

Population Based ◽

Localized Prostate Cancer ◽

Black And White ◽

Treatment Decision Making

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Racial Differences in Treatment Decision-Making for Men with Clinically Localized Prostate Cancer: a Population-Based Study

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-015-0109-8 ◽

2015 ◽

Vol 3 (1) ◽

pp. 35-45 ◽

Cited By ~ 14

Author(s):

Jinping Xu ◽

James Janisse ◽

Julie Ruterbusch ◽

Joel Ager ◽

Kendra L. Schwartz

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Racial Differences ◽

Treatment Decision ◽

Population Based ◽

Localized Prostate Cancer ◽

Population Based Study ◽

Treatment Decision Making

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Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer

Patient Education and Counseling ◽

10.1016/j.pec.2016.09.012 ◽

2017 ◽

Vol 100 (2) ◽

pp. 267-275 ◽

Cited By ~ 4

Author(s):

Lixin Song ◽

Christina Tyler ◽

Margaret F. Clayton ◽

Eleanor Rodgiriguez-Rassi ◽

Latorya Hill ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Family Communication ◽

Decision Aid ◽

Treatment Decision ◽

Localized Prostate Cancer ◽

Treatment Decision Making

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Factors underlying treatment decision-making for localized prostate cancer in the U.S. and Canada: A scoping review using principal component analysis

Canadian Urological Association Journal ◽

10.5489/cuaj.5538 ◽

2018 ◽

Vol 13 (7) ◽

Cited By ~ 2

Author(s):

Mustafa Andkhoie ◽

Desneige Meyer ◽

Michael Szafron

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Principal Component Analysis ◽

Scoping Review ◽

Principal Component ◽

Treatment Decision ◽

Localized Prostate Cancer ◽

Key Factors ◽

Treatment Decision Making ◽

Word Cloud

Introduction: The purpose of this research is to gather, collate, and identify key factors commonly studied in localized prostate cancer (LPC) treatment decision-making in Canada and the U.S.Methods: This scoping review uses five databases (Medline, EMBASE, CINAHL, AMED, and PsycInfo) to identify relevant articles using a list of inclusion and exclusion criteria applied by two reviewers. A list of topics describing the themes of the articles was extracted and key factors were identified using principal component analysis (PCA). A word cloud of titles and abstracts of the relevant articles was created to identify complementary results to the PCA.Results: This review identified 77 relevant articles describing 32 topics related to LPC treatment decision-making. The PCA grouped these 32 topics into five key factors commonly studied in LPC treatment decision-making: 1) treatment type; 2) socioeconomic/demographic characteristics; 3) personal reasons for treatment choice; 4) psychology of treatment decision experience; and 5) level of involvement in the decision-making process. The word cloud identified common phrases that were complementary to the factors identified through the PCA.Conclusions: This research identifies several possible factors impacting LPC treatment decision-making. Further research needs to be completed to determine the impact that these factors have in the LPC treatment decision-making experience.

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Associations between patient knowledge of others' experiences and treatment choice in men with localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6578 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6578-6578

Author(s):

Aaron J. Katz ◽

Ying Cao ◽

Xinglei Shen ◽

Deborah Usinger ◽

Sarah Walden ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

North Carolina ◽

Cancer Patients ◽

Treatment Options ◽

Population Based ◽

Treatment Choice ◽

Localized Prostate Cancer ◽

The North ◽

Patient Reported

6578 Background: Men with localized prostate cancer must select from multiple treatment options, without one clear best choice. Consequently, personal factors, such as knowing other prostate cancer patients who have undergone treatment, may influence patient decision-making. However, associations between knowledge about others’ experiences and treatment decision-making among localized prostate cancer patients has not been well characterized. We used data from a population-based cohort of localized prostate cancer patients to examine whether patient-reported knowledge of others’ experiences is associated with treatment choice. Methods: The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) is a population-based cohort of localized prostate cancer patients enrolled from 2011-2013 throughout the state of North Carolina in collaboration with the North Carolina Central Cancer Registry. All patients were enrolled prior to treatment and followed prospectively. Patient decision-making factors including knowledge of others’ experiences with prostate cancer treatment options were collected through patient report. Patient treatment choice was determined through medical record abstraction and cancer registry data. Results: Among 1,202 patients, 17% reported knowing someone who pursued active surveillance (AS) while 28%, 46%, and 59% reported knowing someone who received brachytherapy, external beam radiation (EBRT), or radical prostatectomy (RP), respectively; 26% underwent AS, 9% brachytherapy, 21% EBRT, and 39% RP as their initial treatment. In unadjusted analyses, patients with knowledge of others’ experiences with brachytherapy, EBRT or RP had more than twice the odds of receiving that treatment compared to patients who did not. Knowledge of others’ experience with AS was not associated with choice to undergo AS. Multivariable analysis adjusting for age, race, risk group, and patient-reported goals of care showed knowledge of others’ experiences with brachytherapy (OR 4.60, 95% confidence interval [CI] 2.76 to 7.68), EBRT (OR 2.38, 95% CI 1.69 to 3.34), or RP (OR 4.02, 95% CI 2.84 to 5.70) was significantly associated with odds of receiving that treatment. The odds of receiving a particular treatment option were further increased among patients who reported knowing someone who had a “good” experience with the treatment in question. Conclusions: This is the first population-based study to directly demonstrate the impact of a patient’s knowledge of others’ experiences on treatment choice in prostate cancer. These data provide a new consideration to clinicians in their counseling of patients with newly diagnosed prostate cancer, and also impacts research into the informed decision-making process for this disease.

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