Patient Preferences and Treatment Decisions for Prostate Cancer: Results From A Statewide Urological Quality Improvement Collaborative

Paudel, Roshan; Ferrante, Stephanie; Qi, Ji; Dunn, Rodney L.; Berry, Donna L.; Semerjian, Alice; Brede, Christopher; George, Arvin; Lane, Brian R.; Ginsburg, Kevin; Montie, James E.; Lane, Giulia I.

doi:10.1016/j.urology.2021.04.020

Cited by 8 publications

(9 citation statements)

References 22 publications

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“…Most reported reasons for AS were potential negative side effects of surgery and trust in their clinician, which is in line with our findings [34] . Similar to our study, several studies in the context of prostate cancer report that men who had a preference for AS experienced more SDM compared to men opting for CT [35] , [36] and reported higher trust in their clinician [37] . Furthermore, although potential side effects of treatment are considerably different, men with low-grade prostate cancer also reported avoiding side effects as an important reason for preferring AS over active treatment [36] .…”

Section: Discussionsupporting

confidence: 89%

“…Similar to our study, several studies in the context of prostate cancer report that men who had a preference for AS experienced more SDM compared to men opting for CT [35] , [36] and reported higher trust in their clinician [37] . Furthermore, although potential side effects of treatment are considerably different, men with low-grade prostate cancer also reported avoiding side effects as an important reason for preferring AS over active treatment [36] . Notably, an important motive in men opting for active treatment is cancer eradication/preventing cancer worry [38] which is also in line with the findings in our study.…”

Section: Discussionsupporting

confidence: 89%

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Active surveillance versus treatment in low-risk DCIS: Women’s preferences in the LORD-trial

Schmitz

Engelhardt

Gerritsma

et al. 2023

European Journal of Cancer

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Active surveillance versus treatment in low-risk DCIS: Women’s preferences in the LORD-trial

Schmitz

Engelhardt

Gerritsma

et al. 2023

European Journal of Cancer

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“…In an analysis of data from the first trial of the P3P intervention [ 18 ], Bosco and colleagues [ 9 ] found that 47% of participants preferred a treatment option that was incongruent with their priority concerns. More recently, in a study of 509 individuals who completed P3P as part of clinical care, Paudel and colleagues [ 19 ] found that 67% of participants made treatment decisions that aligned with the influence of potential adverse treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…A little influence 509 individuals who completed P3P as part of clinical care, Paudel and colleagues [19] found that 67% of participants made treatment decisions that aligned with the influence of potential adverse treatment outcomes. One possible explanation for the modest rates of preference concordance in this and other studies is that measures of patients' preferences may be susceptible to ceiling effects [9,20].…”

Section: Discussionmentioning

confidence: 99%

Concordance between influential adverse treatment outcomes and localized prostate cancer treatment decisions

Pozzar

Xiong

Hong

et al. 2022

BMC Med Inform Decis Mak

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Background Although treatment decisions for localized prostate cancer (LPC) are preference-sensitive, the extent to which individuals with LPC receive preference-concordant treatment is unclear. In a sample of individuals with LPC, the purpose of this study was to (a) assess concordance between the influence of potential adverse treatment outcomes and treatment choice; (b) determine whether receipt of a decision aid predicts higher odds of concordance; and (c) identify predictors of concordance from a set of participant characteristics and influential personal factors. Methods Participants reported the influence of potential adverse treatment outcomes and personal factors on treatment decisions at baseline. Preference-concordant treatment was defined as (a) any treatment if risk of adverse outcomes did not have a lot of influence, (b) active surveillance if risk of adverse outcomes had a lot of influence, or (c) radical prostatectomy or active surveillance if risk of adverse bowel outcomes had a lot of influence and risk of other adverse outcomes did not have a lot of influence. Data were analyzed using descriptive statistics and logistic regression. Results Of 224 participants, 137 (61%) pursued treatment concordant with preferences related to adverse treatment outcomes. Receipt of a decision aid did not predict higher odds of concordance. Low tumor risk and age ≥ 60 years predicted higher odds of concordance, while attributing a lot of influence to the impact of treatment on recreation predicted lower odds of concordance. Conclusions Risk of potential adverse treatment outcomes may not be the foremost consideration of some patients with LPC. Assessment of the relative importance of patients’ stated values and preferences is warranted in the setting of LPC treatment decision making. Clinical trial registration: NCT01844999 (www.clinicaltrials.gov).

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“…In a total of 509 men with PCa, Paudel et al assessed the Personal Patient Profile-Prostate (P3P), a self-reported questionnaire that collects information on the bladder, bowel, or sexual problems and their influence on the decision making of treatment modalities [ 87 ]. The authors noted that men who suffered bladder, bowel, and sexual problems as having ‘a lot of influence’ on their treatment-decision chose AS, and further suggested that many men in the elderly population who have less concern over these problems may not choose AS [ 87 ].…”

Section: Patient Preferencementioning

confidence: 99%

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

Yamada

Taguchi

Kume

2022

Cancers

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Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate ‘surgically fit’ patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively.

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Patient Preferences and Treatment Decisions for Prostate Cancer: Results From A Statewide Urological Quality Improvement Collaborative

Cited by 8 publications

References 22 publications

Active surveillance versus treatment in low-risk DCIS: Women’s preferences in the LORD-trial

Active surveillance versus treatment in low-risk DCIS: Women’s preferences in the LORD-trial

Concordance between influential adverse treatment outcomes and localized prostate cancer treatment decisions

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

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