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Study Shows Importance of Informed Decision Making

A new study has again highlighted the importance of prostate cancer patients being informed of all treatment options, including radiation therapy.

The Prostatectomy versus Radiotherapy for Early-stage Prostate Cancer (PREPaRE) study explored how men with prostate cancer choose treatment when robotic surgery and radiation therapy are options.

It discovered that robotic prostatectomy was mistakenly believed to provide a more definitive cure than radiation therapy and that patients needed more balanced information about alternative treatments, including radiation therapy.

Study investigator Ben Smith, Co-Deputy Director (Policy and Practice) at the Centre for Oncology Education and Research Translation at the Ingham Institute for Applied Medical Research and University of NSW, said the results underlined how prostate cancer patients must be better informed about treatment options.

“There’s a clear need for patients to hear balanced information about ALL treatment options open to them,” Dr Smith said. “They also need this information earlier in the decision-making process.”

“Hopefully this study will encourage patients to consider other treatment options for prostate cancer, which have been found to be equally effective.”

Dr Ben Smith says the new study underlines the importance of men being able to make informed decisions about treatment.

 

The PREPaRE study has been published in the Patient Education and Counseling Journal and featured interviews with 25 prostate cancer patients in Australia.

They were questioned about information/decision-making needs before and/or after attending a combined clinic in which they consulted a urologist and a radiation oncologist about treatment options.

The study found that information provided by clinicians was crucial in influencing which treatment option patients selected, with patients heavily influenced by their clinician’s guidance.

“Men had seen their urologist at least twice before talking to a radiation oncologist, and consequently many already had a strong preference for robotic surgery,” Dr Smith said.  “It did seem, however, that when patients received information on all treatment options their treatment choice was more balanced between robotic prostatectomy and radiotherapy.

Of ten men who had not already made a definite decision about their treatment, six chose surgery and four chose radiation therapy.

Irrespective of their treatment choice, all men involved in the study said they had benefited from talking to both a radiation oncologist and a urologist.

“Unfortunately, the way the system works in Australia at the moment is that patients are not getting full information about radiation therapy.  We need to improve access to information to allow patients to make the best decisions for them.”

Dr Smith said a team from South Western Sydney Local Health District, Macarthur Urology and Lake Macquarie Urology is now trialing a Question Prompt List – a basic information guide for prostate cancer patients on all treatment options, supported by the ANZUP Below the Belt Research Fund.

Approximately half of the Australians and New Zealanders diagnosed with cancer (over 100,000 people) each year could benefit from radiation therapy. Radiation therapy is a part of the treatment program in around 40% of all patients cured of their cancer.

Last year RANZCR’s Faculty of Radiation Oncology released a Position Statement calling for prostate cancer patients to have better access to information on treatment options, including seeing a radiation oncologist as well as a urologist prior to treatment. Click here to read it.

The Targeting Cancer website has a wealth of information on radiation therapy and how it can help treat cancer. Click here for more information.