Table 4.

Factors influencing treatment decisions among low-risk prostate cancer patients in the Greater San Francisco Bay Area according to patients and physicians

Themes	Description
Age and stage of life	• At older ages, preference for avoiding definitive treatment options. Main factors considered:  o More comorbidities  o Higher risk of death from other causes  o Shorter life expectancy • At younger ages, opinions varied. Factors for favoring definitive treatment options:  o Healthier status to handle complications and having a faster recovery  o Longer life expectancy  o Quick and definitive action versus longer duration of active surveillance Factors for favoring other options:  o Delay of definitive treatment at the possibility of mild disease  o Interest in preserving body functions
Side effects	• Fear of side effects affecting well-being and physical functioning  o Hair loss, nausea, erectile dysfunction, incontinence • Experiences of side effects during past medical encounters  o Other procedures- complications • Family opinions  o Disregarding patients’ concerns about side effects and urging definitive treatments as the best options to ensure they live longer
Facilitators of meaningful clinical conversations about treatment	• Differences in expectations and the level of difficulty for clinical conversations based on information needs and resources between patients and physicians  o Physicians perceived that higher patient medical literacy made conversations easier and more informative  o Perceptions of the role of health literacy less prominent among patients • Prior knowledge and the support of family/friends  o Friends/family sometimes advocated for more aggressive treatments  o Importance of support for patient’s decisions about treatment