'Mismatched' prostate cancer treatment more common tha... (of treatment mismatches the research tea...)

'Mismatched' prostate cancer treatment more common than expected

Date:11/25/2007

of treatment mismatches, the research team enrolled patients treated for early prostate cancer at four Boston centers over a six-year period. Study participants completed a questionnaire before beginning treatment and subsequent questionnaires at intervals of 3, 12, 24 and 36 months after they entered the study. They also gave the researchers who were not involved in their clinical care permission to review their medical records. The questionnaires were designed to assess urinary incontinence and other urinary problems, along with bowel and sexual dysfunction. Participants were also asked to assess their level of distress with any symptoms they experienced.

Of the almost 440 patients who completed the entire study, 389 or 89 percent reported having some level of urinary, bowel or sexual problem before beginning treatment. Those participants were classified into four groups. Group 1 was patients with serious symptoms in a single area, for whom decisions would be expected to be the most straightforward. Group 2 had less serious symptoms that would count against a single treatment option. Group 3 had problems in several areas but still had one potentially appropriate treatment. Group 4 included those patients with significant dysfunction in all three areas, for whom none of the treatment options would be recommended.

The study results showed similar levels of treatment mismatches in all groups 34 percent in Group 1, 37 percent in Group 2, and 40 percent in Group 3. Among Group 4 patients those with dysfunction in all three areas only 5 percent chose watchful waiting, a strategy in which they receive no treatment but are followed closely by their medical team. Since patients take many considerations into account when choosing therapies, the surveys asked about several factors that might affect those decisions, none of which could account for the mismatched choices. As expected, patients reporting pre-existing conditions were more lik
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

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