Open Access

ARTICLE

Factors infl uencing treatment decisions in patients with low risk prostate cancer referred to a brachytherapy clinic

Daniel Taussky¹, Aihua Liu², Michal Abrahamowicz², Eve Léger-Bélanger¹, Jean-Paul Bahary¹, Marie-Claude Beauchemin¹, Thu Van Nguyen¹, David Donath¹, Fred Saad³

1 Department of Radiation, University of Montreal Medical Center (CHUM), Montreal, Quebec, Canada
2 Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
3 Department of Urology, University of Montreal Medical Center (CHUM), Montreal, Quebec, Canada
Address correspondence to Dr. Daniel Taussky, Department of Radiation Oncology, CHUM – Hôpital Notre-Dame, 1560 Sherbrooke St. E., Montreal, Quebec H2L 4M1 Canada

Canadian Journal of Urology 2008, 15(6), 4415-4420.

Abstract

Objective: The present study aimed to analyze factors influencing treatment decisions in patients diagnosed with low risk prostate cancer who were referred to a brachytherapy clinic and had to choose from four treatment options: expectant management (watchful waiting), radical prostatectomy, external beam radiation therapy, and permanent seed brachytherapy.
Methods: We analyzed factors that influenced the treatment decisions of 110 consecutive patients with low risk prostate cancer who were referred to a brachytherapy clinic in a hospital in Montreal, Canada. These factors included patient age, marital status, and profession, as well as referral source (a urologist or a radiation oncologist), and distance and driving time from the patient's home to the medical center. Cost was not a factor as the procedure is covered under the Canadian healthcare system.
Results: Of the 110 patients, 53 patients (48.2%) chose permanent seed brachytherapy, 33 patients (31.8%) chose expectant management, 12 patients (10.9%) chose external beam radiation therapy, and 10 patients (9.1%) chose radical prostatectomy. Patients who chose brachytherapy were significantly younger than those who chose external beam radiation therapy (p = 0.011). Patients living further away from the hospital than the median distance of 19.85 miles were more likely to choose brachytherapy than expectant management (p = 0.017).

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