Recall and attitudes in patients with prostate cancer

To assess the ability of men with adenocarcinoma of the prostate to recall aspects of testing leading to their diagnosis, recall of the informed consent process, and their satisfaction with treatment and that treatment's impact on their lives.

A Gallup Organization telephone survey of a national sample of 421 men with known prostate cancer randomly selected from a pool of men identified during "National Prostate Cancer Awareness Week" was performed from November 1995 to January 1996. Men were queried about diagnostic tests performed to make the diagnosis of prostate cancer, reasons for being "tested," sources of importance in helping men make an informed treatment decision, informed consent discussions, treatment satisfaction, treatment-related quality of life, and the quality of ongoing physicians' care.

Patients' recall of procedures performed to diagnose prostate cancer is poor; less than 20% remember having a "biopsy." More than 80% depended entirely on their attending urologist for informed consent and education about prostate cancer management. Forty percent sustained a complication as a result of their treatment, primarily impacting their sexual or urinary function. Ongoing follow-up care provided by physicians was reported as poor in the management of sexual or urinary problems by 50% and 33% of patients, respectively.

Patients are generally satisfied with the care process for prostate cancer. However, the lack of patient recall for diagnostic procedures makes the adequacy of the current informed consent process questionable and suggests the need for increased efforts at improving patient education.