Making decisions about treatment for localized prostate cancer

S. K. Steginga, S. Occhipinti, R. A. Gardiner, J. Yaxley, P. Heathcote

Research output: Journal article publicationJournal articleAcademic researchpeer-review

123 Citations (Scopus)

Abstract

Objective: To describe the decision-making processes used by men diagnosed with localized prostate cancer who were considering treatment. Patients and methods: Men newly diagnosed with localized prostate cancer from outpatient urology clinics and urologists' private practices were approached before treatment. Their decision-making processes and information-seeking behaviour was assessed; demographic information was also obtained. Results: Of 119 men approached, 108 (90%) were interviewed; 91% reported non-systematic decision processes, with deferral to the doctor, positive and negative recollections of others' cancer experiences, and the pre-existing belief that surgery is a better cancer treatment being most common. For systematic information processing the mean (SD, range) number of items considered was 4.19 (2.28, 0-11), with 57% of men considering four or fewer treatment/medical aspects of prostate cancer. Men most commonly considered cancer stage (59%), urinary incontinence (55%) and impotence (51%) after surgery, and low overall mortality (45%). Uncertainty about probabilities for cure was reported by 43% of men and fear of cancer spread by 37%. Men also described uncertainty about the probabilities of side-effects (27%), decisional uncertainty (25%) and anticipated decisional regret (18%). Overall, 73% of men sought information about prostate cancer from external sources, most commonly the Internet, followed by family and friends. Conclusions: In general, men did not use information about medical treatments comprehensively or systematically when making treatment decisions, and their processing of medical information was biased by their previous beliefs about cancer and health. These findings have implications for the provision of informational and decisional support to men considering prostate cancer treatment.

Original languageEnglish
Pages (from-to)255-260
Number of pages6
JournalBJU International
Volume89
Issue number3
DOIs
Publication statusPublished - 2002

Keywords

  • Decision making
  • Prostate cancer
  • Treatment

ASJC Scopus subject areas

  • Urology

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