Most men with localized prostate cancer do not clearly understand the risks associated with different treatment options, according to a recent study in BJU International.
Common side effects of treatment include erectile dysfunction (ED), loss of libido, and urinary incontinence, along with ejaculatory and orgasm difficulties.
While the three main modes of treatment – radical prostatectomy, radiotherapy, and active surveillance – have similar mortality rates, they have different side effects. Knowing more about them could help patients make more informed decisions, the authors suggested.
The study involved 426 men with newly diagnosed localized prostate cancer. The men completed questionnaires on their treatment perspectives after being informed of their options, but before treatment began.
Sixty-eight percent of the men were not clear that the risk of cancer recurrence was similar for radical prostatectomy and radiotherapy. And over half did not realize that, when compared to radiotherapy, radical prostatectomy carried higher risk for urinary incontinence and erectile dysfunction, but not bowel issues.
Forty-five percent thought that active surveillance definitely led to later treatment, when in fact treatments were conducted only if necessary.
Talking to a radiotherapist or nurse specialist was associated with better understanding of risks.
For clinicians, “greater efforts should be made to better understand why these misperceptions occur and, most importantly, how they can be corrected,” the authors concluded.
Similar findings were presented at the 32nd Annual Congress of the European Association of Urology in London last March.
At that time, Dr. Marie-Anne van Stam (also lead author of the BJU International paper) and colleagues noted that “patients’ perceptions on risks associated to treatment options are probably less accurate than assumed.”
“Health care providers should be aware of these potential biases and their impact on shared decision making,” they added.
Resources
BJU International
Van Stam, Marie-Anne, et al.
“The accuracy of patients’ perceptions of the risks associated with localised prostate cancer treatments”
(Abstract. Online: October 27, 2017)
http://onlinelibrary.wiley.com/wol1/doi/10.1111/bju.14034/abstract
European Urology (Supplement)
Van Stam, Marie-Anne, et al.
“Patients’ perspectives on the risks of localized prostate cancer treatments
prior to making the treatment decision”
(Abstract for 32nd Annual EAU Congress, 24-28 March 2017 in London, United Kingdom)
http://www.eusupplements.europeanurology.com/article/S1569-9056(17)30990-9/pdf
Reuters
Harding, Anne
“Prostate cancer patients unclear on differences among treatments”
(October 11, 2017)
https://www.reuters.com/article/us-health-prostatecancer-treatment-choic/prostate-cancer-patients-unclear-on-differences-among-treatments-idUSKBN1CG2VA
WebsEdgeHealth via YouTube
“Patients and treatment decisions – EAU 2017”
(Video interview with Marie-Anne van Stam. Posted: March 27, 2017)
https://www.youtube.com/watch?v=ttlCFBPp3r4