Treatment decision‐making strategies and influences in patients with localized prostate carcinoma

Abstract

The chin, or mentum osseum, is one of the most distinctive anatomical traits of modern humans. A variety of hypotheses for the adaptive value of the chin have been proposed, ranging from mechanical stress resistance to sexual selection via mate choice. While the sexual selection hypothesis predicts dimorphism in chin shape, most biomechanical hypotheses preclude it. Therefore determining the presence or absence of significant sexual dimorphism in chin shape provides a useful method for differentiating between various adaptive hypotheses; however, this has yet to be done due to a lack of quantitative data on chin shape. The goals of this study are therefore: (1) to introduce a new method for quantifying chin shape and (2) to determine the presence or absence of sexual dimorphism in chin shape in a diverse sample of modern humans. Samples were drawn from recent human skeletal collections representing nine geographic regions. Outlines of mentum osseum contours were quantified using elliptical Fourier function analysis (EFFA). Fourier coefficients were analyzed using principal components analysis (PCA). Sexual dimorphism in chin shape was assessed using PC loadings in the pooled geographic sample, and statistically significant differences were found. These findings provide the first quantitative, morphologically based evidence in support of adaptive hypotheses that predict dimorphism in chin shape, including the sexual selection hypothesis. Am J Phys Anthropol 143:417‐425, 2010. © 2010 Wiley‐Liss, Inc.

Psychological and Social Factors influencing Patients’ Treatment Selection for Localised Prostate Cancer

“…Many of the patients perceived their cancer as a localised problem and that the most tangible and definitive method of curing or preventing the disease from spreading was to remove the tumour [27-29, 31, 35]. These findings were also replicated in three of the quantitative studies, which reported that beliefs about the effectiveness of surgery and complete tumour removal were statistically associated with selecting surgery [33][34][35]. Surgery would also allow for surgeons to be more informed about the nature and extent of the cancer and would provide the patients with more information about their disease [27,28].…”

“…Patients' beliefs and other influences in selecting to undergo a radical prostatectomy were clearly reported in nine of the studies [27][28][29][30][31][32][33][34][35]. Many of the patients perceived their cancer as a localised problem and that the most tangible and definitive method of curing or preventing the disease from spreading was to remove the tumour [27-29, 31, 35].…”

Treatment decision making in prostate cancer: Patients’ participation in complex decisions

“…Medical decision making for PC is difficult. Sometimes for professionals, often for patients [12,26]. It is important to keep in mind that the individual patient may or may not feel comfortable with the responsibility of choosing between the available treatment options and too much encouragement towards active involvement in TDM may lead to unwanted control [27].…”

“…[9][10][11][12] However, little is known about patients' actual participation in TDM. As it has been demonstrated that cancer patients' preferred and assumed roles in TDM match in approximately 35-65% of the cases [13][14][15][16][17], role preferences are not a reliable indication of patients' level of participation.…”

Quality of life in young men after radical prostatectomy

“…[2][3][4] In addition, urinary and sexual function are known to worsen with age 5 and functional and health-related quality of life (HRQOL) outcomes are of great importance for young men treated with curative intent for prostate cancer. 6,7 Urinary and sexual bother, or distress, after radical prostatectomy (RP) may be different for younger men if they have better baseline urinary and sexual function. For example, if younger men have higher baseline function, then any decrease in function may be associated with more significant bother than in older men.…”