Factors associated with treatment received by men diagnosed with prostate cancer in Queensland, Australia
Faculty of Computing, Health and Science
ECU Health and Wellness Institute
OBJECTIVE: • To examine demographic, clinical and quality-of-life indicators for the treatments received by men diagnosed with prostate cancer in Australia. SUBJECTS AND METHODS: • This prospective trial included men diagnosed with prostate cancer (n= 1064, response rate = 82%) between 2005 and 2007 in Queensland, Australia, sampled from urologists and hospital outpatient clinics. • Data were collected through telephone interviews and self-administered questionnaires. • Treatment received was categorized into five groups: radical prostatectomy; radiation therapy with neoadjuvant androgen deprivation therapy (ADT); radiation therapy alone; ADT alone; and monitoring. RESULTS: • Sharp contrasts in the choice between radical prostatectomy (47% of men) vs radiation therapy with ADT (30%) were evident among age at diagnosis, travel time to facilities offering radiation treatment, Gleason score, stage, body mass index and physical health. • Men who underwent surgery were younger and of above average physical health, and had lower grade cancers; men who underwent radiation therapy were older and less fit. ADT, in both neoadjuvant and definitive forms, was administered for high-risk and more advanced disease. • Two-thirds (66%) of men stated that they made the final treatment selection themselves. CONCLUSIONS: • These results suggest that men's baseline health and tumour characteristics influence treatment choices. • Distance from tertiary treatment centres also influenced the treatment received and access to specialist urologists may play a role. • With most men indicating high levels of decisional control, the importance of having quality up-to-date information readily available to guide their decisions cannot be overstated.