Abstract
Background: Given the importance of physician attitudes about different treatments and the quality of life (QOL) in prostate cancer, we performed a national survey of specialists to assess treatment recommendations and perceptions of treatment-related survival and QOL. Methods: We mailed a self-administered survey instrument to a random sample of 1366 specialists in the US. Respondents were asked for treatment recommendations and survival that varied by PSA levels and Gleason scores and estimate QOL outcomes. Pearson's chi-square and multivariable regression models were used to test for differences in each outcome. Results: Response rates were similar for radiation oncologists (52.6%) and urologists (52.3%; P=0.92). Across all risk strata, urologists were more likely to recommend surgery than were radiation oncologists, for conditions ranging from PSA>20 and Gleason score 8-10 (35.2 vs 0.2%; P<0.001) to PSA 4-10 and Gleason score 7 (87.5 vs 20.9%; P<0.001). Radiation oncologists were also more likely to recommend radiation therapy relative to urologists (all P<0.001). From low- to high-risk prostate cancer, radiation oncologists and urologists perceived their treatment as being better for improving survival (all P<0.001). Each specialty also viewed their treatment as having less urinary incontinence (all P<0.001). Conclusions: Radiation oncologists and urologists both prefer the treatment modalities they offer, perceive them to be more effective and to lead to a better QOL. Patients may be receiving biased information, and a truly informed consent process with shared decision-making may be possible only if they are evaluated by both specialties before deciding upon a treatment course.
Original language | English (US) |
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Pages (from-to) | 163-169 |
Number of pages | 7 |
Journal | Prostate Cancer and Prostatic Diseases |
Volume | 17 |
Issue number | 2 |
DOIs | |
State | Published - Jun 2014 |
Externally published | Yes |
Keywords
- outcomes
- quality of life
- survey
- treatment recommendations
ASJC Scopus subject areas
- Oncology
- Urology
- Cancer Research