title: Unanticipated and underappreciated outcomes during management of local stage prostate cancer: a prospective survey.
abstract: OBJECTIVE
  Due to the complexity of factors that must be considered when choosing a therapy for prostate cancer, we hypothesized that many men will find that certain factors such as side effects gain or lose importance after therapy relative to their expectations before therapy.
  
  
  METHODS
  We conducted a prospective survey of men deciding on a therapy for local stage prostate cancer in 3 geographic regions. Men were asked to rate the importance of 11 personal factors before starting therapy and again 6 months after therapy.
  
  
  RESULTS
  Among 448 eligible men completing the most common treatment options, overall satisfaction with treatment choice was high across all therapies. While most men changed rankings of importance in at least 1 of the 11 factors, the majority of pre-post evaluations were highly consistent. In adjusted analyses the 2 factors that emerged as significantly underappreciated for all major prostate cancer treatments were 1) the impact of treatment on usual daily activities, and 2) the recommendations of friends and relatives who were affected with prostate cancer.
  
  
  CONCLUSIONS
  Initial patient expectations of the importance of the majority of factors related to prostate cancer treatment are generally accurate. Better counseling may improve the accuracy of patient expectations of the personal burden of treatment, and their evaluation of the advice of affected friends and relatives.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. sramsey@fhcrc.org
authors.forename: Scott D
authors.initials: SD
authors.lastname: Ramsey
authors.forename: Steven B
authors.initials: SB
authors.lastname: Zeliadt
authors.forename: Neeraj K
authors.initials: NK
authors.lastname: Arora
authors.forename: David K
authors.initials: DK
authors.lastname: Blough
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
authors.forename: Ingrid
authors.initials: I
authors.lastname: Oakley-Girvan
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Fedorenko
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Potosky
mesh_terms: D000368:Aged; D002755:Choice Behavior; D003657:Decision Making; D005163:Factor Analysis, Statistical; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome