title: Understanding participation in a trial comparing cryotherapy and radiation treatment.
abstract: BACKGROUND
  To date, few two-arm active treatment randomized control trials (RCTs) have compared prostate cancer therapies.
  
  
  OBJECTIVE
  To examine the difference and similarities between the reasons for accepting and declining participation in a two-arm active treatment RCT comparing external beam radiation therapy (EBRT) versus cryotherapy.
  
  
  METHODS
  Eleven men with prostate cancer, selected purposively, participated in a 30-minute post-treatment semi-structured interview. Interviews were transcribed verbatim, coded and analyzed for patterns with the assistance of the text management (TM) software (NVivo).
  
  
  RESULTS
  RCT accepters participated principally with the hope of being randomized into the cryotherapy treatment arm. Consequently, randomization into the EBRT arm was often perceived as receiving the consolation prize. RCT decliners were either pushed away from cryotherapy and/or pulled towards another treatment (surgery, EBRT, brachytherapy). Factors influencing accepters'/decliners' treatment decisions include (1) personal factors such as patient research and treatment preference, cancer survivors, family/friends, and altruism, and (2) physician, trial, and treatment factors such as patient-physician rapport, RCT awareness and understanding, therapy convenience, expected outcome and perceived side effects.
  
  
  CONCLUSIONS
  By better understanding patients' views about RCT participation, recruitment rates for prostate cancer RCTs can be improved.
authors.affiliation: Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Eng
authors.forename: Liam
authors.initials: L
authors.lastname: Taylor
authors.forename: Marja
authors.initials: M
authors.lastname: Verhoef
authors.forename: Scott
authors.initials: S
authors.lastname: Ernst
authors.forename: Bryan
authors.initials: B
authors.lastname: Donnelly
mesh_terms: D017679:Cryotherapy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D011795:Surveys and Questionnaires