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Fear Factor in Early Prostate Cancer
Aug. 4, 2006 -- Men with early prostate cancer may choose treatments based partly on fear and misconceptions about their options.
So says a study in the journal Cancer.
Doctors should help patients set fear aside and weigh all the facts before choosing a treatment, write the researchers, who work at University of Colorado Health Sciences Center in Denver.
Thomas Denberg, MD, PhD, and colleagues interviewed 20 men with newly diagnosed, early- stage prostate cancer. The men's cancer hadn't spread outside the prostate.
All of the men were urology outpatients at Veterans Affairs Medical Center in Denver. They ranged in age from 54-80 years (average age: 65).
Treatment Options
The men were all eligible for at least two of the following options:
- Prostatectomy: surgery to remove the prostate
- External-beam radiation: radiation beamed at the tumor from outside the body
- Brachytherapy: implanting permanent radioactive "seeds" in the prostate
- Hormonal ablation: hormone therapy to slow the cancer's growth by curbing testosterone
- Cryotherapy: freezing cancer cells with liquid nitrogen
- Watchful waiting: monitoring the cancer without immediate medical treatment
The researchers interviewed the men before and after the patients chose their treatments.
The first interview happened within a week after the men first started talking to doctors about treatment options.
That interview, which lasted 60-90 minutes, covered the men's feelings about their prostate cancer diagnosis and treatment options.
Six to eight months later, the researchers followed up with a brief phone interview.
Fear Factor
The researchers spotted three factors that seemed to be big influences on the men's treatment choices. All three factors had drawbacks.
The first factor was "profound fear and uncertainty, often corresponding with a desire to receive treatment as quickly as possible," write Denberg and colleagues.
Most patients (16 out of 20) didn't want to get a second opinion because they didn't want to waste time and add uncertainty to their situation, the researchers note.
Prostate cancer Prostate cancer often grows slowly. Most of the patients in Denberg's study knew that. But knowing something in your brain doesn't always override fear.
"Even though most patients volunteered that prostate cancercancer is 'slow growing,' this abstract knowledge did little to dispel the vividly frightening, yet unlikely prospect of prostate cancer suddenly 'exploding,'" the researchers write.
Misconceptions About Choices
The second factor was "influential misconceptions about treatment, especially prostatectomy," the researchers note.
For instance, eight men (40% of the group) said that they thought surgery was to get rid of the cancer for good.
That's not necessarily true, say the researchers. They cite other research on the effectiveness of radiation therapy for early prostate cancer.
Another 11 men (55% of the group) had "equally strong but negative feelings" about surgery, calling it "drastic" and even voicing fears about dying in surgery, the researchers note.
The interviews also revealed other mistaken beliefs among the men. For instance, some patients confused radiation therapy with chemotherapy, the study shows.
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Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
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