Prostate cancer patients willing to make trade-offs between survival, side effects
medwireNews: Men with a new diagnosis of nonmetastatic prostate cancer say they would accept small reductions in survival odds if that meant fewer side effects and an improved quality of life, suggests the COMPARE study.
The discrete choice experiment included 634 men aged an average 67.7 years with localized disease (74% low and intermediate risk, 26% high risk) for whom no treatment decision had been made. They were given two hypothetical treatment options that differed according to the effect on survival, recovery time, need for further treatment, and side effects, such as incontinence and impotence. The question was repeated with different options with varying effects on these outcomes.
As reported at the 2018 NCRI Conference in Glasgow, UK, although survival was the top priority for the study participants, they were not averse to the idea of trade-offs between survival and side effects. For instance, in the low–moderate risk group, men were willing to forego a 0.46% chance of improved cancer-specific survival for a 1% improvement in urinary function, and a 0.19% chance of survival for a 1% improvement in erectile function.
Speaking to medwireNews, study author Hashim Ahmed (Imperial College London, UK) said that “sometimes as cancer physicians we assume that patients want survival at any cost” and what this study has shown is that that isn’t necessarily the case, especially when the survival benefit of the available treatments has been shown in three randomized trials to be small, yet the impact on quality of life can be great.
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