Patient preferences for management of localized prostate cancer.
We designed this study to determine whether patients with early localized prostate cancer prefer surgical intervention over watchful waiting, which aspects of the 2 management strategies influence patient preferences, and whether there are patient characteristics that predict their preferences for 1 strategy over the other. Structured interviews were used with 140 male patients seen consecutively at a university-based Department of Veterans Affairs Medical Center outpatient clinic. The mean age of the patients was 66.3 years. Of the 140 patients, 53% preferred surgical treatment, 42% preferred observation, 4% preferred that their physician make the decision, and 1% preferred radiotherapy. Of 74 patients selecting surgical intervention, 92% (68) reported that the possibility of complete tumor removal was the strongest factor influencing their decision. Of those selecting observation, 80% (47/59) reported being most influenced by the complications of an operation. Older patients were significantly (P < .002) more likely to prefer expectant management. We conclude that tumor excision is an important factor influencing patient preferences for treatment, irrespective of survival benefits. This factor should be considered when designing approaches to providing information to patients about alternative treatments.
Mazur
D J
DJ
Medical Service and Health Services Research and Development, Department of Veterans Affairs Medical Center, Portland, Oregon 97201, USA.
Hickam
D H
DH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003657:Decision Making; D005544:Forecasting; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010353:Patient Education as Topic; D010358:Patient Participation; D010817:Physician-Patient Relations; D011183:Postoperative Complications; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate