Prostate cancer: Beware of biased treatment advice
date: 6/27/2007
Subscribe to ConsumerReportsHealth.org to learn about your best treatment options for prostate cancer.
Men diagnosed with prostate cancer face several treatment choices--and they often neglect their own preferences because of biased, incomplete or confusing information from doctors, research suggests.
Experts disagree whether the best treatment for prostate cancer is surgery, radiation, or “watchful waiting,” in which an apparently slow-growing tumor is monitored before risking treatments that can cause impotence or incontinence. Because of that uncertainty, patients lean heavily on their doctors’ opinions.
But doctors may give falsely optimistic information about the effectiveness of treatment, and they tend to downplay the side effects, according to a review of 69 studies of how men choose prostate-cancer treatment, published in the journal Cancer. For example, the review cited an evaluation of the educational materials that doctors give prostate-cancer patients, which found that most are biased toward active treatment. Less than half gave hard numbers about the frequency of side effects. Less than a third discussed watchful waiting. In another study cited, only 16 percent of prostate-cancer patients recalled discussing the potential side effects of the treatment options. But all the doctors said they thoroughly explained the side effects.
Those communication failures may help explain a puzzling finding: While men are greatly concerned about side effects, they seem to overlook them when choosing a treatment. Instead, they focus almost entirely on its ability to eradicate cancer, perhaps because the side-effect information is meager or confusing.
If you’re diagnosed with prostate cancer, the findings highlight the importance of learning as much as possible about each option--including watchful waiting--and of asking questions until you’re sure you understand. Since urologists tend to favor surgery and radiologists lean toward radiation therapy, consider seeking opinions from both specialists, and getting an independent opinion from an oncologist. That’s particularly important if you sense the doctor hasn’t considered your preferences.
Experts disagree whether the best treatment for prostate cancer is surgery, radiation, or “watchful waiting,” in which an apparently slow-growing tumor is monitored before risking treatments that can cause impotence or incontinence. Because of that uncertainty, patients lean heavily on their doctors’ opinions.
But doctors may give falsely optimistic information about the effectiveness of treatment, and they tend to downplay the side effects, according to a review of 69 studies of how men choose prostate-cancer treatment, published in the journal Cancer. For example, the review cited an evaluation of the educational materials that doctors give prostate-cancer patients, which found that most are biased toward active treatment. Less than half gave hard numbers about the frequency of side effects. Less than a third discussed watchful waiting. In another study cited, only 16 percent of prostate-cancer patients recalled discussing the potential side effects of the treatment options. But all the doctors said they thoroughly explained the side effects.
Those communication failures may help explain a puzzling finding: While men are greatly concerned about side effects, they seem to overlook them when choosing a treatment. Instead, they focus almost entirely on its ability to eradicate cancer, perhaps because the side-effect information is meager or confusing.
If you’re diagnosed with prostate cancer, the findings highlight the importance of learning as much as possible about each option--including watchful waiting--and of asking questions until you’re sure you understand. Since urologists tend to favor surgery and radiologists lean toward radiation therapy, consider seeking opinions from both specialists, and getting an independent opinion from an oncologist. That’s particularly important if you sense the doctor hasn’t considered your preferences.
This article first appeared in the June 2007 issue of Consumer Reports on Health.
This site is for your information only. For medical advice, consult a health professional.
