Long Term Survivors of Prostate Cancer Express Treatment Decision Regret for Up to 15 Years

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Greater initial education and support could help mitigate later treatment decision regret in prostate cancer survivors.
Greater initial education and support could help mitigate later treatment decision regret in prostate cancer survivors.

Educating men more effectively about treatment options may help relieve treatment decision regret in long term survivors of localized prostate cancer, according to a study published in the Journal of Clinical Oncology.

Patients and clinicians are often uncertain which treatment options are ideal in prostate cancer as complications arising from therapy, such as urinary incontinence and sexual dysfunction, have negative implications for long term qualify of life.

The study identified 934 surviving participants who responded to an initial survey gathering data on socioeconomic, clinical, and demographic factors at 1, 2, 5, and 15 years. The 15-year follow up survey additionally addressed the impact treatment had on finances, relationships, physical function, as well as PSA concerns, outlook, perceptions of having made an informed decision, and regret.

Approximately 15% of patients surveyed — 16.6% of radiotherapy patients, 15.0% of surgery patients, and 8.2% of patients who received conservative treatment — expressed treatment decision regret.

Patients reported moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51-5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04-5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.0-1.02), as factors most associated with regret.

Regret is not expressed by the majority of long term survivors of prostate cancer 15 years after initial diagnosis, but study authors conclude saying “[improved] supporting initial treatment decision making through informing patients about treatment options and potential outcomes, helping patients identify treatment preferences, and clarifying values might help mitigate regret over the long term.”

Reference

1. Hoffman RM, Lo M, Clark JA, et al. Treatment decision regret among long-term survivors of localized prostate cancer: results from the prostate cancer outcomes study [published online May 11, 2017]. J Clin Oncol. doi: 10.1200/JOC.2016.70.6317

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