Impact of pre-treatment counselling on decisional regret of prostate cancer survivors: Cross-sectional analysis of patient-reported experience following diagnosis or treatment.

Abstract

Prostate cancer (PCa) impacts patient lives beyond oncologic concerns alone. PCa survivorship entails all impacts of PCa, from time of diagnosis to end of life. This may include decision regret (DR). We aimed to determine survivor experiences from a functional perspective throughout survivorship. Our cross-sectional survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Questions explored patient understanding of functional impacts concerning treatment. Survey items included binary and Likert scale questions, and an open-answered question asking how care may be improved. Responses were used to identify predictors of DR. A total of 514 patients received our survey with a response rate of 23.7% (n=122). Most survivors were offered radical prostatectomy (RP) or radiation therapy, at 73.0% and 63.9%, respectively; 14.9% reported lacking understanding of treatment impact on erections. Similarly, 11.5% reported lacking understanding of treatment on urinary continence. Predictors of DR included treatment with RP and low pre-treatment understanding of potential erectile dysfunction (ED) and urinary incontinence. PCa survivors are at high risk of DR, particularly those who undergo treatment with RP and those who identify as having low pre-treatment understanding of potential ED and urinary incontinence. Virtual care did not impact DR. Results highlight the importance of thorough counselling on functional aspects of PCa management prior to treatment.