Different factors can influence prostate cancer treatment decisions, which can manifest in various ways across racial and ethnic groups. One study analyzed these differences, with findings that may provide guidance for future research.
Clinical guidelines suggest that patients with low-risk prostate cancer engage in active surveillance (AS), which includes prostate-specific antigen (PSA) testing, rectal examination, and prostate biopsy. With AS, patients can delay the need for curative therapies that can potentially reduce their quality of life. However, not all patients receive AS. In addition, the success of AS depends on a variety of factors, such as trust in provider recommendations and apprehension about treatment side effects, among others.
A study published in Cancer Medicine analyzed qualitative data on treatment decision-making in patients with prostate cancer. Researchers emphasized differences and similarities in sociocultural factors among racial and ethnic groups. A group comprising 43 Chinese, Filipino, Hispanic/Latino, Black, and White patients with low- or very low-risk prostate cancer were interviewed about their decision-making processes.
Three central themes were identified among racial and ethnic groups in regard to the treatment decision-making process, including social expectations surrounding gender, religion or spirituality, and past healthcare experiences. Socialized masculinity appeared to play a role in how patients felt about different treatments, religion and spirituality helped ease anxiety related to AS, and past healthcare experiences dictated certain aspects of decision-making. For example, some patients showed mistrust of provider recommendations based on past healthcare experiences.
The study sought to improve our understanding of the different factors that influence decision-making in certain groups of patients, which could help lead to more personalized communication with patients about their therapy. In addition, the insights from this study help identify potential gaps in how we understand patients and their backgrounds, past experiences, and treatment decisions.
Guan, A., Shim, J. K., Allen, L., Kuo, M. C., Lau, K., Loya, Z., Brooks, J. D., Carroll, P. R., Cheng, I., Chung, B. I., DeRouen, M. C., Frosch, D. L., Golden, T., Leppert, J. T., Lichtensztajn, D. Y., Lu, Q., Oh, D. L., Sieh, W., Wadhwa, M., . . . Shariff-Marco, S. (2022). Factors that influence treatment decisions: A qualitative study of racially and ethnically diverse patients with low- and very-low risk prostate cancer. Cancer Med. https://doi.org/10.1002/cam4.5405