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 OncologyCitation Excerpt :Therefore, in recent guidelines, conservative management is recommended for patients with low-risk prostate cancer with a life expectancy of <10 years [2,3]. However, Gorin et al. reported that only 36% of patients with low-risk prostate cancer were provided with an active surveillance option by the physicians [14]. There is a tendency to hesitate choosing conservative management for several reasons.
Survey 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 :Our current systematic review highlights the need for improved validated methods for patient and physician education to facilitate the uptake of AS among men with LRPC. Moreover, studies suggesting that clinician's bias may influence the treatment decision-making process [26,32,33,41,46,47,50,51] suggest that educational efforts aimed at clinicians and frameworks for how they deliver the information on treatment options [44] are important for increasing the acceptance of AS. Education, appropriate information, and support aimed at both patients and their families have long been recognised as important in the management of chronic conditions [77,78], with studies demonstrating an increase in adherence to treatment plans where these have been established.