Patients' preferences for the management of non-metastatic prostate cancer: discrete choice experiment.
OBJECTIVE
To establish which attributes of conservative treatments for prostate cancer are most important to men.


METHODS
Discrete choice experiment.


METHODS
Two London hospitals.


METHODS
129 men with non-metastatic prostate cancer, mean age 70 years; 69 of 118 (58%) with T stage 1 or 2 cancer at diagnosis.


METHODS
Men's preferences for, and trade-offs between, the attributes of diarrhoea, hot flushes, ability to maintain an erection, breast swelling or tenderness, physical energy, sex drive, life expectancy, and out of pocket expenses.


RESULTS
The men's responses to changes in attributes were all statistically significant. When asked to assume a starting life expectancy of five years, the men were willing to make trade-offs between life expectancy and side effects. On average, they were most willing to give up life expectancy to avoid limitations in physical energy (mean three months) and least willing to trade life expectancy to avoid hot flushes (mean 0.6 months to move from a moderate to mild level or from mild to none).


CONCLUSIONS
Men with prostate cancer are willing to participate in a relatively complex exercise that weighs up the advantages and disadvantages of various conservative treatments for their condition. They were willing to trade off some life expectancy to be relieved of the burden of troublesome side effects such as limitations in physical energy.
Sculpher
Mark
M
Centre for Health Economics, University of York, Heslington, York YO10 5DD. mjs23@york.ac.uk
Bryan
Stirling
S
Fry
Pat
P
de Winter
Patricia
P
Payne
Heather
H
Emberton
Mark
M
D000368:Aged; D002755:Choice Behavior; D017281:Cost of Illness; D007172:Erectile Dysfunction / Q000209:etiology; D006306:Health Surveys; D006801:Humans; D007989:Libido; D008017:Life Expectancy; D008131:London; D008297:Male; D017060:Patient Satisfaction; D010809:Physical Fitness; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires