Study: Men's choice of prostate Ca treatment based primarily on perception

Men with prostate cancer generally make treatment decisions based on differences in the information they receive rather than their own preferences, according to a study to be published in the May 1 issue of Cancer. The review of studies in prostate cancer decision making suggests that a lack of medical evidence and consistent, comprehensive messages about therapeutic options compel men to turn to a wide variety of popular and biased sources that influence their decision, thus resulting in treatments that do not generally reflect patients’ goals.

Steven B. Zeliadt, PhD, MPH, of the Fred Hutchinson Cancer Center in Seattle, and colleagues synthesized data from other studies to examine how and why men with prostate cancer make treatment decisions. A review of current literature shows that cancer eradication or control was the foremost treatment objective, and minimizing side effects played a minor role. However, studies report a gap between patient treatment objectives and the evidence supporting the efficacy of the treatment chosen. In choosing treatment, patients did not consistently rely on scientific evidence of a therapy’s efficacy to control disease or to prolong life.

Physicians and family, as well as race and culture, may affect patients’ decisions, but the degree of their respective influence varies in the literature and is often poorly measured, according to Dr. Zeliadt’s group. Notably, physicians tended to present therapies in ways that were both confusing and dismissive of patient concerns about risks, which biased patients’ decisions or turned patients to other sources of information, the authors reported.

“The perceptions of treatment efficacy related to cancer control far outweigh available supporting evidence, and most patients appear to select a prostate cancer treatment primarily based on its perceived ability to control the tumor,” the authors stated.