Long-term information on lifestyle changes among prostate survivors is lacking. In this nationwide, population-based study we investigated the prevalence of lifestyle changes, factors associated with lifestyle changes and associations between lifestyle changes and general quality of life.
All men registered in the National Prostate Cancer Register of Sweden diagnosed in 2008 with low-risk prostate cancer at age 70?years or younger were sent a questionnaire. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals for factors potentially associated with lifestyle change.
Out of 1288, 1720 men (75%) were responded. A total of 279 (22%) reported a positive lifestyle change regarding diet or exercise. Poor functional outcomes after treatment was associated with exercising less (OR 1.6, 95% CI 1.2-2.1) and less interest in social activities and relationships (OR 1.8, 95% CI 1.5-2.1). Men who exercised more (OR 7.9, 95% CI 4.4-14) and men who had an increased interest in relationships and social activities (OR 5.2, 95% CI 2.1-13) reported higher general quality of life.
A considerable proportion of men reported making positive lifestyle changes after the prostate cancer diagnosis. The time after diagnosis may be a teachable moment that facilitates lifestyle interventions. Poor functional outcomes after treatment may reduce the willingness to engage in positive lifestyle change, which need be considered when supporting men after treatment. Men who made a positive lifestyle change, regardless of whether it was exercise or regarding relationships and social activities more often reported a high level of general quality of life.
We developed a decision aid for patients with curable prostate cancer based on Svenson's DiffCon Theory of Decision Making. This study was designed to determine if surrogate patients using the aid could understand the information presented, complete all tasks, show evidence of differentiation, and arrive at a preferred treatment choice.
Men, at least 50 years old and never diagnosed with prostate cancer, were recruited through local advertisements. Participants were asked to imagine that they were a case-scenario patient. Then they completed the decision aid interview, which included three components: (i) information presentation, with comprehension questions, (ii) exercises to help identify attributes important to the decision, and (iii) value-clarification exercises.
Sixty-nine men volunteered. They had a mean age of 61.2 (range 50-83) years, 37% had no formal education beyond high school, and 87% were living with a partner. All participants completed all aspects of the interview. They answered an average of 10 comprehension questions each, with a mean of 94.7% correct without a prompt. Each attribute in the information presented was identified by at least one participant as important to his decision. Participants identified a median of five attributes as important (ranges 1-14) at each of three points during the interview; 75% changed at least one important attribute during the interview. Forty-nine per cent of participants also identified attributes as important that were not included in the presented information. Participants showed a wide range of values in each of seven trade-off exercises. Eighty-eight per cent of participants showed evidence of differentiation; 75% had a clear treatment preference by the end of the interview.
Our decision aid appears to meet its goals for surrogate patients and illustrates the strengths of the DiffCon theory. The ability of the aid to accommodate wide variability, both in information needs and in important attributes, is a particular strength of the decision aid. It now requires testing in patients with prostate cancer.
The purpose of this study was to identify factors that are associated with quality of life (QoL) in relapse-free patients after radical prostatectomy or high-dose radiotherapy with or without hormone treatment.
A cross-sectional postal survey among members of the Norwegian Prostate Cancer Patient Association was used. We analyzed associations between QoL and general health, "typical" adverse effects (sexual, urinary, and bowel assessed using the Expanded Prostate Cancer Composite items) and psychosocial variables (work ability, family life, social life and/or leisure activities) in univariate and multivariate regression analyses. Statistical significance was defined as P
In 1993, Ron Evason learned that he had prostate cancer. In this article, abbreviated from a speech he delivered last year, he describes his battle with the disease and the steps he has taken to overcome it. He also describes the lessons he has learned, including the need to ask probing questions of physicians.
The purpose of this investigation was to systematically examine the efficacy of providing men with prostate cancer with an audiotape of their primary treatment consultation.
Participants included 425 men newly diagnosed with prostate cancer and 15 radiation oncologists from 4 cancer centers in Canada. Patients were block randomized to one of four consultation groups: 1. Standard care control--not audio-taped; 2. Audio-taped--no audiotape given; 3. Audio-taped--patient given audiotape; and 4. Audio-taped--patient offered choice of receiving audiotape or not (4 patients declined; 94 accepted). Patient outcomes were measured at 12 weeks post-consultation: perceived degree of information provision; audiotape satisfaction and use; communication satisfaction with oncologist; mood state; and cancer-specific quality of life.
Patients receiving the consultation audiotape reported having been provided with significantly more disease and treatment information in general (p=0.04), and more information about treatment alternatives (p=0.04) and treatment side effects (p=0.01) in particular, than patients who did not receive the audiotape. Audiotape benefit was not significantly related to patient satisfaction with communication, mood state or quality of life at 12 weeks post-consultation, and was not significantly affected by choice of receiving the audiotape. Patients rated the audiotape intervention positively, with an average score of 83.0 out of 100.
Consultation audiotapes are rated highly by men with prostate cancer, and these audiotapes help to enhance their perception of having been provided with critical disease- and treatment-related information.
To compare information priorities of Canadian to those of Italian health-care professionals in the context of early-stage prostate cancer.
Oncologists (radiation and medical), nurses, and radiation-therapy technologists in each country were surveyed. Respondents rated the importance of addressing each of 78 questions with a case-scenario patient using either three (Italian survey) or four (Canadian survey) categories; the most important category was defined as "essential" in both countries. At least 67% identical responses on a specific question was considered "agreement."
Within each country, questions rated essential by most group members were similar across professions (all pairwise group correlations r>or=0.77, por=1.59, p
The purpose of this study was to explore prostate cancer patients 'perceptions, feelings, ideas, and experiences regarding making decisions to use (or not use) complementary/alternative medicine (CAM).
Five focus groups were conducted with 29 men diagnosed with prostate cancer. Content analysis of the verbatim transcripts was used to identify key themes in the data.
Decision making about CAM treatments appears to depend on both fixed (e.g., disease characteristics, demographic characteristics, and medical history) and flexible (e.g., perceptions of CAM and conventional medicine, experiences with the health care system and health care practitioners, and perceptions about the need for control or action) decision factors.
The participants in this study appeared more likely to be "pushed" toward using CAM by negative experiences with the health care system than to be "pulled" toward CAM by perceptions about its safety or congruence with their beliefs about health and illness.
To study the cognitive processes of early-stage prostate cancer patients as they determined which treatment they preferred, using our cognitively based decision aid.
The aid was a one-to-one interview that included the structured presentation of information, listing exercises in which the patient identified attributes important to his decision, and trade-off exercises to help him weigh and integrate those attributes together. At various points of the interview, patients identified the attributes they felt were important to their decision, rated their treatment options and completed standardized assessments relating to their decision. In addition, patients participated in a follow-up interview at the time they made their actual treatment decision and again 3 months later.
Sixty of 70 (86%) of the invited patients participated in the study. Participating patients identified a median of four important attributes (range 1-10); 36 different attributes were identified at some point in the interview by the group. During the interview, 78% of patients changed which attributes they considered important, and 72% changed their treatment ratings. Stability of treatment choice after the interview and lack of regret after the decision were each positively associated with increasing differentiation between treatment options over time.
The decision process appears to be dynamic for the patients with great variability across patients in what is important to the decision. Increasing stability of choice and lack of regret appear to be related positively to increasing difference over time in how attractive the preferred option is over its closest competitor, rather than to the size of the difference at any one point in time.
The aim was to describe cancer patients' perceived barriers and facilitators of physical activity during adjuvant cancer treatment.
Semi-structured focus group interviews were conducted with patients with breast cancer (n=9) and colorectal cancer (n=1) and prostate cancer (n=8) undergoing adjuvant cancer treatment. To capture perceived barriers and facilitators before starting treatment, individual interviews with women with breast cancer (n=5) were also conducted. 23 patients in total, were interviewed, and the transcribed interviews were analysed with qualitative content analysis.
Three categories emerged: "Physical and emotional barriers"-addresses experiences of side-effects, co-morbid conditions and emotional barriers, preventing physical activity (PA). "Perspective and attitudes"-how self-efficacy, self-image, preference, concerns, expectations, experience and new perspective regarding one's health influencing PA. "Support and practicalities"-addresses needs of support and information and how practicalities could be a barrier to PA.
Several barriers were side effects of oncological treatment, which can be alleviated by PA. Another barrier was concerns regarding safety of PA during treatment. Communicating benefits and safety of PA to cancer patients early as possible after diagnosis might be beneficial.
Information about PA from health care staff should be given early after diagnosis and as a part of standard care.
AIM: This study aims to determine the predictors for the symptomatic prostate cancer patient's delays in seeking care. METHODS: We followed a cohort of 931 men with prostate cancer from Stockholm County (Sweden) asking about socio-demographic and information-level characteristics as well as the length of delay in seeking care. RESULTS: Of the 511 patients who returned a completed questionnaire, 219 (43%) reported having clinical symptoms before prostate cancer was diagnosed. Of all men with clinical symptoms, self-employed men were more likely to make an early first contact with the health-care system than pensioners or men with other employment (relative risk (RR), 3.9; 95% confidence interval (CI), 1.4-11.0). Men who had obtained moderate or much information from the internet about prostate cancer were more likely to have made an early first contact with the health-care system (RR, 2.2; 95% CI, 1.3-3.9). Men who had obtained moderate or much information from health-care staff (RR, 1.4; 95% CI, 1.0-1.6), or from any doctor (RR, 1.4; 95% CI, 1.0-1.8) or from family members/acquaintances (RR, 1.3; 95% CI, 1.0-1.9) had an early first visit to the health-care system. Men who were 70 to 80 years old started treatment earlier than men who were 50 to 69 years old (RR, 2.3; 95% CI, 1.4-3.6). CONCLUSIONS: The patients' level of information about prostate cancer obtained from the internet and other sources such as the health-care system, doctors or family members/acquaintances coupled with their employment status were influential in leading to early first contact and first visit to the health-care system. Older patients started treatment earlier than younger patients.