Multiple physician recommendations for prostate cancer treatment: a Pandora's box for patients?

OBJECTIVE: Patients turn to their physicians for information and guidance when making a prostate cancer treatment decision. The objectives of this study were to determine the likelihood of men consulting with and receiving treatment recommendations from different providers (urologists, radiation oncologists, and primary care physicians), the content of these recommendations, the perceived influence of recommendations and which recommendations, if any, were associated with prostate cancer treatment decisions. METHODS: One hundred and fifty-eight participants with localized prostate cancer completed a survey regarding their treatment decision-making process. Associations between treatment choice and urologist recommendations, consultations with radiation oncologists and primary care physicians, potential side effects and other factors were examined using regression analysis. RESULTS: Among men consulting multiple providers, more than half received at least one treatment recommendation. Most men chose a treatment recommended by at least one provider. The likelihood of choosing a treatment increased when the urologist recommended it. Consulting a radiation oncologist decreased and increased likelihood of choosing a radical prostatectomy and radiation, respectively. CONCLUSION: Most men consulted multiple providers and received multiple treatment recommendations. Recommendations appear to play a significant role in prostate cancer treatment decision-making.