The Patient: Patient-Centered Outcomes Research

, Volume 1, Issue 3, pp 189–200

Association of Pre-Existing Symptoms with Treatment Decisions among Newly Diagnosed Prostate Cancer Patients


  • Steven B. Zeliadt
    • Fred Hutchinson Cancer Research Center
    • Fred Hutchinson Cancer Research Center
  • Arnold L. Potosky
    • Lombardi Comprehensive Cancer CenterGeorgetown University Medical Center
  • Neeraj K. Arora
    • National Cancer Institute
  • David K. Blough
    • University of Washington
  • Ingrid Oakley-Girvan
    • Northern California Cancer Center
  • Ann S. Hamilton
    • Keck School of MedicineUniversity of Southern California
  • Stephen K. Van Den Eeden
    • Kaiser Permanente
  • David F. Penson
    • University of Southern California/Norris Cancer Center
Original Research Article

DOI: 10.2165/1312067-200801030-00006

Cite this article as:
Zeliadt, S.B., Ramsey, S.D., Potosky, A.L. et al. Patient-Patient-Centered-Outcome-Res (2008) 1: 189. doi:10.2165/1312067-200801030-00006


Background: The choice between surgical and non-surgical treatment options is a fundamental decision for men with local-stage prostate cancer because of differences in risks of genitourinary adverse effects among available treatments.

Objectives: We assessed whether pre-existing genitourinary symptoms at the time of diagnosis influenced men’s preferences for surgery over other management options.

Methods: We recruited 593 patients with newly diagnosed local-stage prostate cancer prior to initiating treatment from an integrated healthcare system, an academic urology center, and community urology clinics. We used logistic regression to compare whether men had a preference for non-surgical options or only preferred surgery.

Results: Nearly 60% of participants indicated that they were considering non-surgical options. Age and clinical characteristics but not pre-existing genitourinary symptoms influenced the decision between surgical or non-surgical options. A total of 62% of men reported adverse effects as a main factor in their treatment decision. Men with more aggressive tumor types were less likely to consider adverse effects; however, men who reported poor ability to have an erection were more likely to consider adverse effects in their treatment decision (p < 0.001).

Conclusion: Sexual dysfunction at time of diagnosis, but not other genitourinary symptoms, is associated with men considering treatment-related adverse effects when considering surgery versus other options. Men who are not experiencing sexual dysfunction at diagnosis may discount the risks of adverse effects in the decision-making process.

Supplementary material

40271_2012_1030189_MOESM1_ESM.pdf (89 kb)
Supplementary material, approximately 91 KB.

Copyright information

© Adis Data Information BV 2008