Associations Between Knowledge of Others’ Experiences and Patient Perceptions of Treatments for Localized Prostate Cancer

Abstract

<h3>Purpose/Objective(s)</h3> Men with localized prostate cancer (PCa) must select from multiple treatment options, without one clear best choice. Consequently, personal factors, such as knowing other men's experiences with treatment, may influence patient perceptions about a therapy and ultimately, treatment decision-making. However, associations between knowledge of others' experiences and patient perceptions about PCa therapies have not been well characterized. <h3>Materials/Methods</h3> The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study is a population-based cohort of localized PCa patients enrolled from 2011-2013 throughout North Carolina in collaboration with the North Carolina Central Cancer Registry. All patients were enrolled prior to treatment and followed prospectively. Patient knowledge of others' experiences and their perceptions about treatments were collected through patient report. Multivariable analysis adjusted for age, race, risk group, insurance, physician recommendations for treatment, and patient-reported goals of care. <h3>Results</h3> Among 1,205 patients, 28%, 46%, and 59% reported knowing someone who received brachytherapy, external beam radiation (EBRT), or radical prostatectomy (RP), respectively. In multivariable analyses (Table), patients with (vs without) knowledge of someone who had received brachytherapy, EBRT or RP had significantly higher odds of believing the therapy was a good option for a man their age and would allow them to return to normal life quickly. Knowledge of someone who had received brachytherapy or EBRT was also associated with lower odds of reporting concern for being a burden to family and recovery time needed, and trended toward lower odds of concern for adverse effects (AEs). Conversely, patients with knowledge of someone who had received RP had higher odds of reporting concern for recovery time and AEs. Odds of reporting favorable perceptions about a treatment were greater among patients who knew someone who had a "good" experience with the therapy (data not shown due to character limits). <h3>Conclusion</h3> This is the first population-based study to directly demonstrate the influence of patient knowledge about others' experiences on their perceptions of PCa therapies. Our data suggest that information about the benefits and risks of brachytherapy/EBRT vs RP may differ when provided by men with personal treatment experience as opposed to physicians. Table. Multivariable-adjusted analysis of associations between knowledge of someone who received and patient perceptions about brachytherapy, EBRT or RP. [Odds ratio (95% CI)]