Why do patients regret their prostate cancer treatment? A systematic review of regret after treatment for localized prostate cancer

Abstract

This is the first systematic review of regret following treatment for localized prostate cancer. Suggestions for the future study of regret in this setting can be made. These include the use of a standardized scale; recognizing levels of regret as low, medium or high; and separately identifying the decision made when patients have combinations of treatments such as surgery followed by radiotherapy.

Longitudinal regret after treatment for low‐ and intermediate‐risk prostate cancer

“…Additional study strengths include the prospective study design, the racial diversity of the cohort, and the use of the DRS. Other studies have used several different scales to assess decisional regret, but the DRS is the most common and the only scale that has been validated . Use of the DRS may thus facilitate comparisons between this study and others …”

“…Our study results must be generalized with caution, because the study was conducted at a single US military institution. There are also inherent limitations of the DRS, including the lack of standard cut‐points to define high and low levels of regret . Not all patients completed the DRS at each follow‐up, raising concerns of biases due to missing data, but there did not appear to be differences in regret between patients who completed the DRS at the subsequent time point and those who did not (Supporting Table 2).…”

Long‐term decision regret after post‐prostatectomy image‐guided intensity‐modulated radiotherapy

“…Decision regret (DR) is a negative emotion experienced when a patient believes that their outcome may have been better if they had decided differently about their management approach . In the management of localised prostate cancer, DR is particularly important to consider, given the very different management approaches available …”

Prostate Cancer in Elderly Men

“…There was an increase in feelings of regret in those who reported significant side effects such as sexual dysfunction. 31 It is important to keep in mind that older adults make up a heterogeneous population whose background health status varies significantly across patients, and the presence of age-associated issues such as comorbidities, functional status, frailty, and geriatric syndromes significantly increases the risk for having side effects from intervention. However, for those fit or vulnerable individuals with reversible syndromes or the ability to mitigate toxicities through interventions such as prehabilitation, there is a likely benefit from PCa treatment.…”