Skip to main content
PMC home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1996 Jul-Aug;165(1-2):26–30.

Patient preferences for management of localized prostate cancer.

D J Mazur 1, D H Hickam 1
PMCID: PMC1307537  PMID: 8855681

Abstract

We designed this study to determine whether patients with early localized prostate cancer prefer surgical intervention over watchful waiting, which aspects of the 2 management strategies influence patient preferences, and whether there are patient characteristics that predict their preferences for 1 strategy over the other. Structured interviews were used with 140 male patients seen consecutively at a university-based Department of Veterans Affairs Medical Center outpatient clinic. The mean age of the patients was 66.3 years. Of the 140 patients, 53% preferred surgical treatment, 42% preferred observation, 4% preferred that their physician make the decision, and 1% preferred radiotherapy. Of 74 patients selecting surgical intervention, 92% (68) reported that the possibility of complete tumor removal was the strongest factor influencing their decision. Of those selecting observation, 80% (47/59) reported being most influenced by the complications of an operation. Older patients were significantly (P < .002) more likely to prefer expectant management. We conclude that tumor excision is an important factor influencing patient preferences for treatment, irrespective of survival benefits. This factor should be considered when designing approaches to providing information to patients about alternative treatments.

Full text

PDF
26

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Catalona W. J. Expectant management and the natural history of localized prostate cancer. J Urol. 1994 Nov;152(5 Pt 2):1751–1752. doi: 10.1016/s0022-5347(17)32377-7. [DOI] [PubMed] [Google Scholar]
  2. Catalona W. J. Management of cancer of the prostate. N Engl J Med. 1994 Oct 13;331(15):996–1004. doi: 10.1056/NEJM199410133311507. [DOI] [PubMed] [Google Scholar]
  3. Chodak G. W., Thisted R. A., Gerber G. S., Johansson J. E., Adolfsson J., Jones G. W., Chisholm G. D., Moskovitz B., Livne P. M., Warner J. Results of conservative management of clinically localized prostate cancer. N Engl J Med. 1994 Jan 27;330(4):242–248. doi: 10.1056/NEJM199401273300403. [DOI] [PubMed] [Google Scholar]
  4. HILTON G. The present position relating to cancer of the lung. Results with radiotherapy alone. Thorax. 1960 Mar;15:17–18. [PubMed] [Google Scholar]
  5. Johansson J. E., Adami H. O., Andersson S. O., Bergström R., Holmberg L., Krusemo U. B. High 10-year survival rate in patients with early, untreated prostatic cancer. JAMA. 1992 Apr 22;267(16):2191–2196. [PubMed] [Google Scholar]
  6. Mazur D. J., Hickam D. H. Interpretation of graphic data by patients in a general medicine clinic. J Gen Intern Med. 1990 Sep-Oct;5(5):402–405. doi: 10.1007/BF02599425. [DOI] [PubMed] [Google Scholar]
  7. Mazur D. J., Hickam D. H. Treatment preferences of patients and physicians: influences of summary data when framing effects are controlled. Med Decis Making. 1990 Jan-Mar;10(1):2–5. doi: 10.1177/0272989X9001000102. [DOI] [PubMed] [Google Scholar]
  8. Mazur D. J., Hickman D. H. Patient preferences: survival vs quality-of-life considerations. J Gen Intern Med. 1993 Jul;8(7):374–377. doi: 10.1007/BF02600076. [DOI] [PubMed] [Google Scholar]
  9. Mazur D. J., Merz J. F. How the manner of presentation of data influences older patients in determining their treatment preferences. J Am Geriatr Soc. 1993 Mar;41(3):223–228. doi: 10.1111/j.1532-5415.1993.tb06696.x. [DOI] [PubMed] [Google Scholar]
  10. McNeil B. J., Pauker S. G., Sox H. C., Jr, Tversky A. On the elicitation of preferences for alternative therapies. N Engl J Med. 1982 May 27;306(21):1259–1262. doi: 10.1056/NEJM198205273062103. [DOI] [PubMed] [Google Scholar]
  11. McNeil B. J., Weichselbaum R., Pauker S. G. Fallacy of the five-year survival in lung cancer. N Engl J Med. 1978 Dec 21;299(25):1397–1401. doi: 10.1056/NEJM197812212992506. [DOI] [PubMed] [Google Scholar]
  12. McNeil B. J., Weichselbaum R., Pauker S. G. Speech and survival: tradeoffs between quality and quantity of life in laryngeal cancer. N Engl J Med. 1981 Oct 22;305(17):982–987. doi: 10.1056/NEJM198110223051704. [DOI] [PubMed] [Google Scholar]
  13. Middleton R. G., Thompson I. M., Austenfeld M. S., Cooner W. H., Correa R. J., Gibbons R. P., Miller H. C., Oesterling J. E., Resnick M. I., Smalley S. R. Prostate Cancer Clinical Guidelines Panel Summary report on the management of clinically localized prostate cancer. The American Urological Association. J Urol. 1995 Dec;154(6):2144–2148. [PubMed] [Google Scholar]
  14. Mountain C. F., Carr D. T., Anderson W. A. A system for the clinical staging of lung cancer. Am J Roentgenol Radium Ther Nucl Med. 1974 Jan;120(1):130–138. doi: 10.2214/ajr.120.1.130. [DOI] [PubMed] [Google Scholar]
  15. Wilson R. G., Hart A., Dawes P. J. Mastectomy or conservation: the patient's choice. BMJ. 1988 Nov 5;297(6657):1167–1169. doi: 10.1136/bmj.297.6657.1167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wilt T. J., Brawer M. K. The Prostate Cancer Intervention Versus Observation Trial: a randomized trial comparing radical prostatectomy versus expectant management for the treatment of clinically localized prostate cancer. J Urol. 1994 Nov;152(5 Pt 2):1910–1914. doi: 10.1016/s0022-5347(17)32413-8. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES