Early prostate cancer--which treatment do men prefer and why?

Area of Science:

• Urology
• Oncology
• Health Psychology

Background:

• Limited understanding exists regarding men's decision-making processes for early prostate cancer treatments.
• Data on patient perspectives before and after definitive therapy are scarce, highlighting a need for further research.

Purpose of the Study:

• To identify the primary reasons men with localized prostate cancer choose between treatment options.
• To investigate the relationship between treatment type and patient satisfaction following therapy.

Main Methods:

• A prospective cohort study involving 768 men with early prostate cancer (stage T1/2, Gleason≤7, PSA<20 ug/L).
• Patients received counseling from a multidisciplinary team before choosing between radical prostatectomy, brachytherapy, conformal radiotherapy, or active surveillance.
• Pre-treatment decision rationales were recorded, and post-treatment satisfaction was assessed via postal questionnaires.

Main Results:

• Treatment choices included radical prostatectomy (40%), conformal radiotherapy (31%), brachytherapy (21%), and active surveillance (8%).
• Key motivators were cancer removal for surgery, fear of other treatments for radiotherapy, and lifestyle convenience for brachytherapy.
• High satisfaction rates were reported, with 87.6% satisfied/extremely satisfied and 92.9% indicating they would choose the same treatment again.

Conclusions:

• Men with early prostate cancer make treatment decisions based on distinct, identifiable reasons.
• Overall patient satisfaction with chosen treatments is high, with a strong likelihood of repeating the same choice.
• The findings suggest that current decision-making support for prostate cancer patients is effective.