HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mohan, R. Articles by Schellhammer, P. Search for Related Content PubMed PubMed Citation Articles by Mohan, R. Articles by Schellhammer, P. Social Bookmarking                      What's this?

Patients’ Survival Expectations before Localized Prostate Cancer Treatment by Treatment Status

the Department of Family and Community Medicine (RM, LL), Eastern Virginia Medical School, Norfolk
the Graduate Program in Public Health (HB), Eastern Virginia Medical School, Norfolk
the Department of Pediatrics (MLB), Eastern Virginia Medical School, Norfolk
the Department of Urology (RL, PS), Eastern Virginia Medical School, Norfolk
the Department of Urology, MD Anderson Cancer Center, Houston, TX (JWD)

Correspondence: Corresponding author: Ravinder Mohan, MD, PhD, Associate Professor, Department of Family and Community Medicine, Eastern Virginia Medical School, 825 Fairfax Avenue, Norfolk, VA 23507 (E-mail: mohanr{at}evms.edu)

Background: Cancer-specific mortality is projected to be only 1% in 15 years in approximately 75% of patients with screen-detected localized prostate cancer (LPC). Nearly 94% of patients choose treatment even though treatment damages health-related quality of life. No data are available regarding what survival benefit patients expected from treatment.

Objectives: A self-administered mailed survey was sent to 184 men with newly diagnosed LPC to query patients about expected survival with treatment versus observation.

Results: More than 90% of patients had at least a high school education and a ninth-grade health literacy. In addition, 68% patients had income of $50,000. Mean cancer grade was 6.6. Twenty-three patients chose observation and 161 patients chose surgery or radiotherapy. Mean comorbidity adjusted life expectancy (CALE) without the cancer was 22.9 years. Without cancer treatment, 15.2% of patients expected to live <5 years, 48.8% 5 to 10 years, 33.5% 11 to 19 years, and 2.4% 20 years. With treatment, survival expectations were <5 years in 0.6%, 5 to 10 years in 6.5%, 11 to 19 years in 30.0%, and 20 years in 62.9% of patients. Age, prostate-specific antigen level, CALE, anxiety, depression, and social support were factors that predicted differences between CALE and patient survival expectations with and without treatment.

Conclusion: LPC patients grossly underestimated their life expectancy without treatment and grossly overestimated the survival benefit of treatment.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				M. A. Bowman and A. V. Neale In This Issue: Mini-Theme on Geriatric Care and Cancer Screening J Am Board Fam Med, May 1, 2009; 22(3): 231 - 233. [Full Text] [PDF]

				G. Warshaw Providing Quality Primary Care to Older Adults J Am Board Fam Med, May 1, 2009; 22(3): 239 - 241. [Full Text] [PDF]