Association of Preexisting Symptoms with Treatment Decisions among Newly Diagnosed Prostate Cancer Patients.

Zeliadt, Steven B. and Ramsey, Scott D. and Potosky, Arnold L. and Arora, Neeraj K. and Blough, David K. and Oakley-Girvan, Ingrid and Hamilton, Ann S. and Van Den Eeden, Stephen K. and Penson, David F. (2008) Association of Preexisting Symptoms with Treatment Decisions among Newly Diagnosed Prostate Cancer Patients. The Patient, 26 (12). pp. 3059-3067. ISSN 1178-1653

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Abstract

BACKGROUND: The choice between surgical versus non-surgical treatment options is a fundamental decision for men with local stage prostate cancer because of differences in risks of genitourinary side effects among available treatments. OBJECTIVES: We assessed whether preexisting genitourinary symptoms at the time of diagnosis influenced men's preferences for surgery versus other management options. METHODS: We recruited 593 patients with newly diagnosed local stage prostate cancer prior to initiating treatment from an integrated health care system, an academic urology center, and community urology clinics. Using logistic regression we compared whether men had a preference for non-surgical options or only preferred surgery. RESULTS: Nearly 60% indicated they were considering non-surgical options. Age and clinical characteristics but not preexisting genitourinary symptoms influenced the decision between preferences for surgical or non-surgical options. A total of 62% of men reported side effects as a main factor in their treatment decision. Men with more aggressive tumor types were less likely to consider side effects, however, men who reported poor ability to have an erection were more likely to consider side effects (p<0.001). CONCLUSION: Sexual dysfunction at time of diagnosis, but not other genitourinary symptoms, is associated with men considering treatment-related side effects when considering surgery versus other options. Men who are not experiencing sexual dysfunction at diagnosis may discount the risks of side effects in the decision making process.

Item Type:	Article or Abstract
Additional Information:	This article is available to subscribers only via the URL above.
DOI:	10.2165/1312067-200801030-00006
PubMed ID:	19096043
NIHMSID:	NIHMS105306
PMCID:	PMC2812903
Grant Numbers:	N01 PC035142, N01 PC035139, N01 PC035136
Keywords or MeSH Headings:	Adult Aged Antigens, CD34/biosynthesis Antigens, CD38/biosynthesis Bone Marrow Cells/metabolism Cell Membrane/metabolism Female Gene Expression Regulation, Leukemic Gene Expression Regulation, Neoplastic* Humans In Situ Hybridization, Fluorescence Interleukin-3 Receptor alpha Subunit/biosynthesis Leukemia, Myeloid, Acute/metabolism Leukemia, Myeloid, Acute/pathology* Male Middle Aged Neoplastic Stem Cells/metabolism Tumor Markers, Biological/metabolism
Subjects:	Therapeutics Diseases > Solid tumors > Prostate cancer
Depositing User:	Library Staff
Date Deposited:	26 Mar 2010 23:16
Last Modified:	14 Feb 2012 14:42
URI:	http://authors.fhcrc.org/id/eprint/220

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