Patient satisfaction with treatment decisions for clinically localized prostate carcinoma. Results from the Prostate Cancer Outcomes Study.
BACKGROUND
Men with early-stage prostate carcinoma can choose aggressive treatment or conservative management. The authors used data from a population-based cohort of men with clinically localized prostate carcinoma to describe satisfaction with treatment decisions 24 months after diagnosis and to examine the association of demographic, socioeconomic, and clinical characteristics with treatment satisfaction.


METHODS
The authors evaluated 2365 men with clinically localized prostate carcinoma, diagnosed between October 1994 and October 1995, in one of six Surveillance, Epidemiology, and End Results tumor registries and who were available for 24 month follow-up. Medical record review and patient-completed surveys provided demographic, socioeconomic, and clinical data and measured treatment satisfaction. Logistic regression analyses were used to identify factors associated with satisfaction.


RESULTS
Overall, 59.2% of subjects were delighted or very pleased with their treatment selection. The perception of being cancer free (66.4%), maintaining urinary (64.2%) and bowel (60.5%) control and normal erectile function (65.9%), having good general health (71.3%), and preserving social relationships (68.1%) were significantly associated with being satisfied (P < 0.05). Men receiving no active treatment were less satisfied (50.5%, P < 0.001) than actively treated men, and Hispanic men were less satisfied than non-Hispanic white men after undergoing radical prostatectomy (50.1% vs. 58.0%, P = 0.05) or androgen deprivation (29.7% vs. 71.8%, P < 0.02).


CONCLUSIONS
The majority of men were satisfied with their treatment selection for clinically localized prostate carcinoma. Receiving an active treatment, believing oneself to be free of cancer, avoiding treatment complications, and having good overall health and social support were positively associated with satisfaction.
Hoffman
Richard M
RM
Medicine Service, New Mexico VA Health Care System, Albuquerque, New Mexico 87108, USA. rhoffman@unm.edu
Hunt
William C
WC
Gilliland
Frank D
FD
Stephenson
Robert A
RA
Potosky
Arnold L
AL
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000523:psychology* / Q000628:therapy*; D003710:Demography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy*; D012959:Socioeconomic Factors; D016896:Treatment Outcome