Factors influencing treatment decisions in patients with low risk prostate cancer referred to a brachytherapy clinic
Taussky Daniel; Liu Aihua; Abrahamowicz Michal; Leger-Belanger Eve; Bahary Jean-Paul; Beauchemin Marie-Claude; Nguyen Van Thu; Donath David; Saad Fred;
Department of Radiation, University of Montreal Medical Center (CHUM), Montreal, Quebec, Canada
OBJECTIVE: The present study aimed to analyze factors influencing treatment decisions in patients diagnosed with low risk prostate cancer who were referred to a brachytherapy clinic and had to choose from four treatment options: expectant management (watchful waiting), radical prostatectomy, external beam radiation therapy, and permanent seed brachytherapy.
METHODS: We analyzed factors that influenced the treatment decisions of 110 consecutive patients with low risk prostate cancer who were referred to a brachytherapy clinic in a hospital in Montreal, Canada. These factors included patient age, marital status, and profession, as well as referral source (a urologist or a radiation oncologist), and distance and driving time from the patient?s home to the medical center. Cost was not a factor as the procedure is covered under the Canadian healthcare system.
RESULTS: Of the 110 patients, 53 patients (48.2%) chose permanent seed brachytherapy, 33 patients (31.8%) chose expectant management, 12 patients (10.9%) chose external beam radiation therapy, and 10 patients (9.1%) chose radical prostatectomy. Patients who chose brachytherapy were significantly younger than those who chose external beam radiation therapy (p = 0.011). Patients living further away from the hospital than the median distance of 19.85 miles were more likely to choose brachytherapy than expectant management (p = 0.017).