PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Prostate cancer and treatment choices -- a decision shared by doctor and patient?

2015-03-26
(Press-News.org) When a man is diagnosed with localised prostate cancer, he usually faces a range of treatment options, from active surveillance to radiation therapy or surgical removal of the prostate. The patient's personal values and preferences should be key in this choice: Is curing the cancer the only thing that matters or should he also consider a variety of quality of life issues, such as avoiding incontinence or erectile dysfunction?

The frequent difficulty in determining the prognosis of localised prostate cancer complicates matters. Many men have low risk prostate cancer that is thought to be slowly progressing and may have no impact on their life expectancy.

The doctor must reach an agreement with the patient when making treatment decisions. However, truly shared decision-making is possible only when the patient understands what the different treatment options entail for him personally, and the doctor understands the patient's personal situation and desires.

"Such truly shared decision-making is a relatively new phenomenon in medicine. Traditionally we assumed that the doctor always knows best," says Kari Tikkinen, Academy of Finland clinical researcher and adjunct professor of clinical epidemiology from the Department of Urology at the Helsinki University Hospital.

Discussing prostate cancer diagnoses and treatment options are part of a urologist's everyday work. Tikkinen wanted to examine the impact of decision aids on the treatment decision. His international research group began to explore the issue through a systematic literature review and meta-analysis.

The meta-analysis identified 14 randomised studies that evaluated the impact of decision aids for the patient's choice of localised prostate cancer treatment. Ten of the studies were conducted in North America, three in Europe, and one in Australia. Together, the studies enrolled 3,377 patients. The average age of the participants was between 61 and 69; they represented a broad range of educational and employment backgrounds, and most were in domestic partnerships.

The most common form of decision aid provided to the patients was written information on the different treatment options. Information was also offered as videos, lectures and discussions, and in some cases, interactive computer applications. Fewer than half of the aids provided had been customised in some way to meet that specific patient's individual need for information.

The aids provided were intended for perusal prior to the clinical consultation to determine treatment. In practice, this meant that the patient bore the primary responsibility for studying and understanding the information.

The impact of the decision aids on the perceived difficulty of the decision as well as patient satisfaction and understanding varied from study to study. Use of the aids seemed to have no effect on the use of any individual treatment option, but two studies suggested a modest impact on reducing feelings of regret about the chosen treatment. The studies did not measure the impact of the decision aids on the flow of the decision process, the time spent making the decision or the costs associated with it, nor did they evaluate the impact of the use of the decision aids on the doctor-patient discussion.

"Studies in other fields of medicine indicate that separate decision aids for the clinical consultation would be beneficial. That way, doctors may ensure that patients sufficiently understand the matter at hand and map their values and choices," Tikkinen states.

According to the first author of the study, Dr. Philippe Violette from the Department of Urology, Woodstock General Hospital, Canada, "Ideally, patients would first receive an information package in the format most useful to them - such as a booklet or an interactive computer application - which they could then study privately or together with his loved ones and nurses before the clinical consultation. In addition, the doctor should have a concise information package available for the appointment, so the patient can revise the main points together with his doctor both visually and in writing."

For any major decision, such as choosing a robot-assisted radical prostatectomy, it is vital that the patient understands what will happen and commits to the decision. "The patient will be more committed to the decision if he is involved in it. This may also lead to better treatment results and, ultimately, to greater satisfaction among both patients and medical staff," Tikkinen points out.

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

Increased sensitivity to climate change in disturbed ecosystems

2015-03-26
Undisturbed ecosystems can be resistant to changing climatic conditions, but this resistance is reduced when ecosystems are subject to natural or anthropogenic disturbances. Plants are particularly sensitive to climatic changes in early life stages and even small climatic changes can cause vegetation shifts when ecosystems are disturbed by fires, insect outbreaks or other disturbances. This is the conclusion from one of the world's longest running climate change experiments conducted by the European network INCREASE, involving scientist from several European countries ...

Optical fiber is used as a sensor, and one is monitored remotely at a distance of 253 kilometers

2015-03-26
This news release is available in Spanish. IMikel Bravo-Acha's PhD thesis has focussed on the applications of optical fibre as a sensor. In the course of his research, conducted at the NUP/UPNA-Public University of Navarre, in the laboratory he monitored a sensor fitted to optical fibre 253 kilometres away. "What is interesting is that the measurement was remote, all the information arrived through the fibre and we didn't need to fit any sockets to power the sensor. This would be very useful, for example, to monitor an oil pipeline crossing the desert where fitting ...

Discovering age-specific brain changes in autism

2015-03-26
CORAL GABLES, Fla. (March 26, 2015) - The field of autism research has tried to find a central theory underlying brain changes associated with autism spectrum disorder (ASD). Now, a new study shows that individuals with the disorder exhibit different patterns of brain connectivity, when compared to typically developing (TD) individuals and that these patterns adjust as the individual ages. "Our findings suggest that developmental stage must be taken into account to accurately build models that show how the brains of individuals with autism differ from neurotypical individuals," ...

Sci-Fly study explores how lifeforms know to be the right size

Sci-Fly study explores how lifeforms know to be the right size
2015-03-26
CINCINNATI - Shakespeare said "to be or not to be" is the question, and now scientists are asking how life forms grow to be the correct size with proportional body parts. Probing deeply into genetics and biology at the earliest moments of embryonic development, researchers at Cincinnati Children's Hospital Medical Center report March 26 in Nature Communications they have found new clues to explain one of nature's biggest mysteries. Their data from fruit flies show the size and patterning accuracy of an embryo depend on the amount of reproductive resources mothers invest ...

Blocking cellular quality control mechanism gives cancer chemotherapy a boost

2015-03-26
A University of Rochester team found a way to make chemotherapy more effective, by stopping a cellular quality-control mechanism, according to a study published today in Nature Communications. The mechanism is known as NMD (nonsense-mediated mRNA decay), and scientists found that exposing breast cancer cells to a molecule that inhibits NMD prior to treatment with doxorubicin, a drug used to treat leukemia, breast, bone, lung and other cancers, hastens cell death. The research team, led by Lynne E. Maquat, Ph.D., director of the Center for RNA Biology at the University ...

Experts unveil 2 ways to identify joint replacement patients at risk for complication

2015-03-26
LAS VEGAS - Orthopedic surgeons from the Perelman School of Medicine at the University of Pennsylvania have developed two new prediction tools aimed at identifying total hip and knee replacement patients who are at-risk of developing serious complications after surgery. The first tool identifies patients who have risk factors that should disqualify them from undergoing same-day (outpatient) or short-stay (overnight) total hip and knee replacement procedures, opting instead for traditional recovery pathways in the hospital. The second tool identifies which patients should ...

Penn Medicine study: In debated surgical procedure, technique trumps technology

2015-03-26
LAS VEGAS - A team of orthopedic surgeons from the Perelman School of Medicine at the University of Pennsylvania has found that modern technology for healing distal femur fractures is as safe and effective as its more established alternative, without a potential shortfall of the older approach. The team found that when done correctly, there are no significant differences between the two approaches - "locked plating" and "non-locked plating" - in terms of healing rates, need for corrective surgery, or hardware failure. The findings are being presented on Thursday, March ...

Middle-age hip replacements nearly double from 2002-2011

2015-03-26
The number of total hip replacements (THRs) nearly doubled among middle-aged patients between 2002-2011, primarily due to the expansion of the middle-aged population in the U.S., according to a new study presented today at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). Continued growth in utilization of hip replacement surgery in patients age 45 to 64, an increase in revision surgeries for this population as they age, and a nearly 30 percent decline in the number of surgeons who perform THR, could have significant implications for future ...

Black patients more likely to be readmitted after hip, knee replacement surgery

2015-03-26
A new study presented today at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that black and Hispanic patients were 62 and 50 percent, respectively, more likely to be readmitted to the hospital within 30 days after total joint replacement (TJR) surgery compared to white patients. In addition, Medicaid patients were 40 percent more likely to be readmitted to the hospital than patients with private insurance. Disparities in the provision of health care services have long been documented, including that black patients utilize hip and ...

Women fare better than men following total knee, hip replacement

2015-03-26
While women may have their first total joint replacement (TJR) at an older age, they are less likely to have complications related to their surgery or require revision surgery, according to a new study presented today at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The findings contradict the theory that TJR is underutilized in female patients because they have worse outcomes then men. Total hip (THR) and total knee replacement (TKR) are common surgical treatments for end-stage arthritis, which causes ongoing pain, limited function and ...

LAST 30 PRESS RELEASES:

Menopause drug reduces hot flashes by more than 70%, international clinical trial finds

FGF21 muscle hormone associated with slow ALS progression and extended survival

Hitting the right note: The healing power of music therapy in the cardiac ICU

Cardiovascular disease risk rises in Mexico, despite improved cholesterol control

Flexible optical touch sensor simultaneously pinpoints pressure strength and location

Achalasia diagnosis simplified to AI plus X-ray

PolyU scholars pioneer smart and sustainable personal cooling technologies to address global extreme heat

NIH grant aims for childhood vaccine against HIV

Menstrual cycle and long COVID: A relation confirmed

WMO report on global water resources: 2024 was characterized by both extreme drought and intense rainfall

New findings explain how a mutation in a cancer-related gen causes pulmonary fibrosis

Thermal trigger

SNU materials science and engineering team identifies reconstruction mechanism of copper alloy catalysts for CO₂ conversion

New book challenges misconceptions about evolution and our place in the tree of life

Decoding a decade of grouper grunts unlocks spawning secrets, shifts

Smart robots revolutionize structural health monitoring

Serum-derived hsa_circ_101555 as a diagnostic biomarker in non-hepatocellular carcinoma chronic liver disease

Korea University study identifies age 70 as cutoff for chemotherapy benefit in colorectal cancer

Study explores brain cell communication called ‘crosstalk’

4 beer and wine discoveries

Massage Therapy Foundation awards $299,465 research grant to Children’s Hospital of Philadelphia

Chung-Ang University develops chloride-resistant Ru nanocatalysts for sustainable hydrogen production from seawater

Afghanistan’s August 2025 earthquake reveals the cost of international isolation, UN scientists warn

Shortlist announced for Panmure House Prize

Small nuclear RNA base editing a safer alternative to CRISPR, UC San Diego researchers find

Can Hayabusa2 touchdown? New study reveals space mission’s target asteroid is tinier and faster than thought

Millisecond windows of time may be key to how we hear, study finds

Graz University of Technology opens up new avenues in lung cancer research with digital cell twin

Exoplanets are not water worlds

Study shows increasing ‘healthy competition’ between menu options nudges patients towards greener, lower-fat hospital food choices

[Press-News.org] Prostate cancer and treatment choices -- a decision shared by doctor and patient?