Contributed by Carla Sharetto| 28 March, 2005 21:14 GMT
Married men diagnosed with prostate cancer were much more likely than unmarried men to choose curative treatment over watchful waiting. They also were more likely than their unmarried counterparts to receive prostatectomy compared with radiation.
Social and cultural have a significant influence on patients' prostate cancer treatment decisions, found a new study published in the May 1, 2005, issue of Cancer, a peer-reviewed journal of the American Cancer Society. The research suggests that such non-medical variables as marital status, high school education, race and ethnic background may play a larger role in patients' attitudes toward treatment than previously believed.
Prostate cancer is now detected earlier than ever because of the introduction of a simple blood test in 1987, the Prostate Specific Antigen (PSA) test. However, the treatment options for prostate cancer -- radical prostatectomy, external beam radiation and brachytherapy -- have not proven to offer a clear mortality benefit versus expectant treatment (that is, observation). Moreover, the treatments can lead to serious side effects, including urinary incontinence, impotence and bowel urgency.
Surgery versus Radiation
It is widely assumed that men make treatment decisions based on medical considerations, such as age, other existing conditions, and the grade of the tumor.
Investigators led by Thomas Denberg, M.D., Ph.D. of the University of Colorado at Denver and Health Sciences Center in Denver reviewed data from 27,920 Hispanic, non-Hispanic, white, and black men without underlying conditions who were registered in the Surveillance, Epidemiology, and End Results (SEER) cancer database.
The investigators found that sociocultural and racial factors independently predicted treatment. Caucasian, black and Hispanic patients were equally likely to receive curative treatments over "watchful waiting" but while Caucasian and Hispanic men were more likely to choose prostatectomy, black men were more likely to be treated with radiation.
Married Men Choose Surgery
Independently, marriage was also an important predictor of treatment: Married men in all three groups were much more likely than unmarried men to receive curative treatment over watchful waiting, and they were also more likely than their unmarried counterparts to receive prostatectomy compared with radiation.
"This study confirmed the hypothesis that sociocultural factors add significant explanatory power to traditional biomedical variables in understanding treatment patterns of early stage prostate cancer," the authors conclude. |
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