Patient Preference and Adherence (Oct 2020)

What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study

  • Oswald LB,
  • Schumacher FA,
  • Gonzalez BD,
  • Moses KA,
  • Penson DF,
  • Morgans AK

Journal volume & issue
Vol. Volume 14
pp. 1949 – 1959

Abstract

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Laura B Oswald,1 Frank A Schumacher,2 Brian D Gonzalez,1 Kelvin A Moses,3 David F Penson,3,4 Alicia K Morgans2 1Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA; 2Department of Medicine (Hematology and Oncology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA; 3Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA; 4Department of Urology, VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USACorrespondence: Alicia K MorgansNorthwestern University Feinberg School of Medicine, 676 N. Saint Clair, Suite 850., Chicago, IL 60611, USATel +1312-695-2381Email [email protected]: Metastatic prostate cancer (mPCa) patients often make complicated treatment decisions, yet decision aids to facilitate shared decision-making for mPCa are uncommon. To inform the development of patient-centered mPCa decision aids, we examined what mPCa survivors considered most important when making treatment decisions.Methods: Using an exploratory sequential approach, we conducted three focus groups with 14 advanced prostate cancer survivors (n=5, n=3, n=6 in each group) to identify considerations for making treatment decisions. Focus groups were audio-recorded and transcribed, and we identified qualitative themes. We then developed a quantitative survey to assess the importance of each theme and administered the survey to mPCa survivors (N=100). We used relative frequencies to determine the most strongly endorsed items and chi-squared and Fisher’s exact tests to assess associations with participant characteristics.Results: Focus groups yielded 11 themes, and the resulting survey included 20 items. The most strongly endorsed mPCa treatment considerations were: relying on physician’s treatment recommendations (79% strongly agree); wanting to feel well enough to spend quality time with loved ones (72% strongly agree); the importance of dying in a manner consistent with one’s wishes (70% strongly agree); hoping to eliminate cancer completely (68% strongly agree); and optimizing treatment efficacy (65% strongly agree). Age, race, marital status, employment status, and self-reported health were related to how strongly men endorsed various considerations for mPCa treatment decision-making.Conclusion: We identified multiple considerations that mPCa survivors appraised when making treatment decisions. These data may inform the development of patient-centered decision aids for mPCa.Keywords: decision-making, focus groups, metastasis, prostate cancer, quality of life

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