Abstract LB-435: Treatment decision-making for clinically localized Gleason score 6 prostate cancer: What younger men choose and why

Abstract

Abstract Introduction: This study identifies various treatment related information sources used by young men with prostate cancer (<50 years) and evaluates the association between decision making preferences and sociodemographic factors. Methods: A survey was sent to 986 men under 50 years of age diagnosed with Gleason 6 prostate cancer from the consult service of one of the authors at Johns Hopkins Department of Pathology between 2001 and 2005. Results: 488 completed questionnaires were received. Physicians and internet were two most common information sources used by the patients. Physicians were a more important information source for white men (p=0.04) and those with higher education (p=0.036). Family was an important information source in married men (p<0.001) and those with higher education (p<0.001). Three most important influential factors for treatment decision were doctor's recommendation, information from internet and spouse's advice. Most patients (88%) consulted more than 2 doctors while making a decision. Men with higher education (p=0.003) and higher income (p=0.003) tend to consult more doctors. Most respondents said that their doctor endorsed only one treatment, primarily surgery. 76% of the respondents said that their doctors recommended against watchful waiting. Men who underwent surgery considered doctor's recommendation as the most influential factor while those who had radiation considered information from internet, books and medical journals as most influential (p=0.018). Treatment choice was not influenced by PSA value at diagnosis. Subjects with higher education and higher income considered sexual function as a more influential factor while making a treatment choice. Better educated men preferred” informed decision making” over “complete reliance on doctor” (p=0.013). Non-married men found the decision more difficult to make (p=0.032), were more worried (p=0.0005) and experienced more distress (p=0.011) while making treatment decisions. Feeling of regret after treatment was experienced more by respondents with lower education (p=0.007) and lower income (p<0.0001). Conclusions: Patients younger than 50 years diagnosed with localized prostate cancer sought information from a wide range of sources but are influenced most by the doctor's recommendation. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-435.