Factors associated with treatment received by men diagnosed with prostate cancer in Queensland, Australia

Abstract

To examine demographic, clinical and quality-of-life indicators for the treatments received by men diagnosed with prostate cancer in Australia. 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. 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 fi t. ADT, in both neoadjuvant and defi nitive forms, was administered for high-risk and more advanced disease. Two-thirds (66%) of men stated that they made the fi nal treatment selection themselves. 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.