Presentation Authors: Behfar Ehdaie*, Elizabeth Schofield, Lauren Gelfarb, New York, NY, Michael Diefenbach, Manhasset, NY, Christian J, New York, NY
Introduction: Active surveillance (AS) is a viable option for men with low risk prostate cancer. Perception of a physicianâ€™s recommendation impacts the patientâ€™s final decision. We evaluated patient factors associated with the perceived suggestion of treatment.
Methods: Since 2011, men with Gleason grade group 1 (GG1) prostate cancer were enrolled in a prospective study to evaluate psychologic factors associated with AS decision making for patients and their spouses. Data collection continues, preliminary results are reported. Patients completed a survey evaluating various psychologic measures prior to making their final decision (baseline) and during follow-up after choosing treatment or AS. We studied the association between patient characteristics and baseline psychologic measures with the patientâ€™s perceived suggestion of treatment. We measured the patientâ€™s perceived suggestion of treatment based on a previously developed scale that distinguishes immediate treatment versus active surveillance. A perceived neutral suggestion of treatment would correlate to values close to zero and strong perceptions of either AS or immediate treatment would be reported as values of -5 and 5, respectively.
Results: Between 2011 and 2018, 189 men with GG1 were enrolled in the study. 174 men had completed the baseline survey and made a treatment decision. 102 men were classified with very low risk prostate cancer ( < 3 cores, < 50% in any core) and 51 were classified as low risk. 31(18%) selected immediate treatment. Overall, 38(22%) perceived the physicianâ€™s suggestion to treatment. On univariate analysis, only younger age was associated with the perceived suggestion of immediate treatment (p=0.02). We did not find a statistically significant association with patient characteristics including education level and ethnicity or baseline psychologic measures including anxiety (Memorial Anxiety Scale for Prostate Cancer), mood (Profile of Mood Status scale), and sense of optimism (Life Orientation Test-Revised). We did not find statistically significant differences in the distributions of patient perceptions of treatment among surgeons (n=7). The results did not change when we assessed the outcome as a strong perceived suggestion to treatment.
Conclusions: Despite a standardized recommendation for AS, we identified varied perceptions of patientsâ€™ assessment of surgeonâ€™s suggestion to immediate treatment vs AS. Physicians who recommend AS should be aware that a significant proportion of patients, especially younger men, perceive their suggestion to immediate treatment.
Source of Funding: 1R21CA164807-01A1