Why do men choose one treatment over another?

Zeliadt, M.P.H. Steven B.; Ramsey, Scott D.; Penson, David F.; Hall, Matt; Ekwueme, Donatus U.; Stroud, M.P.H. Leonard; Lee, Judith W.

doi:10.1002/cncr.21822

Cited by 227 publications

(114 citation statements)

References 85 publications

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“…Physicians, in turn, may assume based on previous experience that older patients desire less information or are no longer capable of adequately processing them. The finding that patients who live alone receive less advice is consistent with the results of other studies indicating that relatives often have more questions than the patients themselves [38]. They want the best for their family member, might be well prepared in consultations, and, as a result, the patients might be better informed.…”

Section: Discussionsupporting

confidence: 89%

Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Jaeger¹,

Weißbach²,

Pfaff³

et al. 2013

JCT

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Purpose: Many studies demonstrate the importance of an empathic communication with prostate cancer patients and show various information needs. Most of the studies are cross sectional. The present analysis aims to 1) provide detailed prospective data on the actual quality of patient information provided by urologists in private practice in Germany; and 2) explore sociodemographic, communicative, and health-and treatment related determinants of the quality of provider-patient-communication. Methods: HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, patient reported outcomes and patients' assessment of patient-physician-communication are documented. A total of 1893 questionnaires at t 0 (initial diagnosis) and t 1 (six months after diagnosis) were analyzed. A linear regression model was estimated. Results: The mean age of the men was 68.38 years, and most lived with their spouse or partner (94.1%). Most patients were informed about treatment options (t 0 96%, t 1 93.2%), but much fewer received information about self-help groups (t 0 36.4%, t 1 45.8%), rehabilitation (t 0 59.9%, t 1 68%), and second medical opinion (t 0 57.2%, t 1 59.3%). Older men (p = 0.02) and men living alone (p = 0.048) received less information than others. Physician empathy (p = 0.000) and prostatectomy treatment (p = 0.020) were positively associated with receiving more information. Conclusion: There is room for improvement in terms of informing prostate cancer patients about rehabilitation, second medical opinion and self-help groups. Urologists being empathetic share more information with their patients. Some patients receive less information than others, especially older patients living alone.

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Section: Discussionsupporting

confidence: 89%

Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Jaeger¹,

Weißbach²,

Pfaff³

et al. 2013

JCT

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“…Personal influences on patient choice may include comfort level with surgery, risks of certain complications such as facial paralysis, feelings toward radiation therapy, desire to have the tumor physically removed, previous personal or family experiences with cancer or brain tumors, and convenience or length of convalescence [16][17][18]. However, physician counseling is often the strongest factor determining treatment selection rather than underlying patient values or preference [38,39].…”

Section: Resultsmentioning

confidence: 98%

Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States

et al. 2016

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The management of small- to medium-sized vestibular schwannoma (VS) remains controversial. Despite a lack of compelling evidence supporting one treatment modality over others, many providers and institutions remain highly biased toward one particular therapy-microsurgery, radiation, or primary observation. The objective of the current study was to estimate the impact of geography on disease presentation and initial treatment of VS in the United States. An analysis of the Surveillance, Epidemiology, and End Results (SEER) database identified 9761 patients with VS that were managed across the 16 SEER geographic registry areas. Univariate analyses demonstrated strong associations between geographic location and tumor size at diagnosis (P < 0.0001). When analyzing the 6115 subjects with tumors between 0 and 3 cm in size, multivariable models identified strong associations between place of residence and treatment modality (P < 0.0001). These multivariable models demonstrated that in many cases the impact of place of residence on treatment selection was greater than other established variables such as tumor size and age. To our knowledge, this is the first study to evaluate geographic trends in VS patient demographics, tumor size and management in the United States. These data suggest that disease presentation and treatment modality are significantly influenced by regional referral patterns, provider or institutional treatment preferences, and regional availability of subspecialty expertise. Understanding geographic bias is important for patients, referring physicians, and treatment providers alike. Until there is clear evidence supporting one therapy over others, multidisciplinary consultation with a minimum of a neurotologist, neurosurgeon, and radiation oncologist or radiosurgeon should be offered in order to provide balanced counseling and accurate informed consent.

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“…Making an informed decision about how to treat one's prostate cancer can be a time filled with anxiety, uncertainty, and stress (Dale et al, 2005;Kaplan et al, 2014;Zeliadt et al, 2006). Treatment options for clinically localized prostate cancer typically include definitive treatment with curative intent, including surgery or radiation therapy; or active surveillance, initial observation followed by definitive treatment if and when it is warranted by disease progression (American Urological Association Education and Research, 2007).…”

Section: Introduction Backgroundmentioning

confidence: 99%

“…Spirituality has been conceptualized as a source of support (Maton, 1989), a cognitive-affective frame for making meaning out of illness (Park, 2007), and as a source of coping resources (Gall, 2004); however these conceptual frameworks do not specifically address the role of spirituality and cancer treatment decision making. Furthermore, there is a dearth of empirical research exploring the role spiritual beliefs might have in improving cancer patients' decision-making experiences (Zeliadt et al, 2006).…”

Section: Introduction Backgroundmentioning

confidence: 99%

Spirituality is associated with better prostate cancer treatment decision making experiences

et al. 2015

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This study examined whether spiritual beliefs are associated with greater decision-making satisfaction, lower decisional conflict and decision-making difficulty with the decision-making process in newly diagnosed men with prostate cancer. Participants were 1114 men diagnosed with localized prostate cancer who had recently made their treatment decision, but had not yet been treated. We used multivariable linear regression to analyze relationships between spirituality and decision-making satisfaction, decisional conflict, and decision-making difficulty, controlling for optimism and resilience, and clinical and sociodemographic factors. Results indicated that greater spirituality was associated with greater decision-making satisfaction (B = 0.02; p < 0.001), less decisional conflict (B = -0.42; p < 0.001), and less decision-making difficulty (B = -0.08; p < 0.001). These results confirm that spiritual beliefs may be a coping resource during the treatment decision-making process. Providing opportunities for patients to integrate their spiritual beliefs and their perceptions of their cancer diagnosis and trajectory could help reduce patient uncertainty and stress during this important phase of cancer care continuum.

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Why do men choose one treatment over another?

Cited by 227 publications

References 85 publications

Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States

Spirituality is associated with better prostate cancer treatment decision making experiences

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