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Men with prostate cancer are willing to accept lower survival to avoid side effects

Men with low/intermediate risk prostate cancer are willing to accept lower survival odds to avoid the negative effects of treatment on urinary continence and erectile function, according to the results of the COMPARE (COMparing treatment options for ProstAte cancer) study which were presented at the National Cancer Research Institute Cancer Conference in Glasgow over the weekend.

COMPARE analysed treatment preferences of 634 men with low/intermediate risk (74%) and (26%) high-risk cancer. The mean age of study participants was 67.7 years old.

Men with low/intermediate risk preferred active surveillance to radical therapy. Type of active treatment did not affect men’s preferences.

The order of impact of treatment-related factors on patient choice was survival, no incontinence, not needing further treatment, and being able to maintain an erection.

However, the marginal rate of substitution showed patients were willing to make trade-offs between side-effects and survival.

On average, patients were willing to trade 0.68%, 0.41% and 0.28% survival benefit in favour of a 1% chance of improved urinary function, requiring no further treatment and maintaining erectile function, respectively.

The study suggests that, while patients value a longer life, they also value quality of life (QoL) and may be willing to choose less treatment on that basis.


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