Health Outcomes ResearchFactors That Influence Patient Enrollment in Active Surveillance for Low-risk Prostate Cancer
Section snippets
AS Protocol
At our institution, AS is offered to PCa patients with the following characteristics: PSA level of ≤10 ng/mL, Gleason score of ≤6, ≤2 positive biopsy cores with tumor of ≤20% in each core, and age ≤80 years.7, 10 Before enrolling in AS, patients receive extensive counseling regarding all treatment options for localized PCa, including AS. Patients are given pamphlets and relevant literature on the different treatment options. With the permission of the patient, family members are invited to
Results
The questionnaire was returned by 105 (57%) of 185 patients. Surveys were not returned during normal follow-up visits but rather by mail as a part of a research protocol. The mean age of the respondents was 65.5 years. Median time enrolled in AS at survey was 20.5 months. AS was offered by the physician who had made the initial diagnosis for 38 (36%) of 105 patients. Statements receiving the greatest number of 1s included: “My doctor thought it was a reasonable alternative”; “I felt sure I
Comment
Patients most frequently reported physician influence as the greatest contributor to their decision to enroll in AS. This finding was consistent with those from other studies that found that patients with PCa rely heavily on the recommendations of physicians in their choice of treatment.13, 14, 15, 16 Thus, physicians should present unbiased information in their discussions with patients. Only 36% of respondents were offered AS by the urologist who had first diagnosed their PCa. Thus, a
Conclusions
Despite guidelines and evidence that support AS for low-risk PCa as an alternative to primary therapy, many physicians failed to introduce this management approach. Of the patients who elect AS, physician influence was most frequently cited as the greatest contributor to their decision for AS. Patients also relied on independent research and the influence of family. Our work has yielded findings similar to other studies that have evaluated factors that influence patient preference for
Acknowledgment
To “CURED” and Vincent A. Rodriguez.
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Update and optimization of active surveillance in prostate cancer in 2021
2021, Actas Urologicas EspanolasRadiotherapy for elder patients aged ≥80 with clinically localized prostate cancer – Brachytherapy enhanced late GU toxicity especially in elderly
2020, Clinical and Translational Radiation OncologySurvey on the practice of active surveillance for prostate cancer from the Middle East
2020, Prostate InternationalFactors Influencing Men's Choice of and Adherence to Active Surveillance for Low-risk Prostate Cancer: A Mixed-method Systematic Review [Figure presented]
2018, European UrologyCitation Excerpt :In contrast, Xu et al [27] found that black men were more likely to report higher levels of “cancer worry”, but that their perception of the negative effects of radical treatment often led to fewer men choosing radical treatment. Eleven of the reviewed studies suggested that the clinician heavily influences the decision-making process [26,32,33,41,44,46,47,50–53]. Scherr et al [53], Liu et al [26], and Davison and Breckon [32] all found that the diagnosing urologist was the most influential clinician associated with AS choice.