Purpose: We conducted a pilot study to examine the acceptability and psychological burden of providing information about the risks and benefits of potential treatment options to men who are scheduling a biopsy, but do not yet know their results. We hypothesize that engaging men in discussions about differences between high and low risk prostate cancer should be done prior to when they are told they have cancer. Prior studies suggest that men have difficulty processing complex information about risk once they are told they have cancer.
Method: We randomized 29 men to receive either (1) a detailed description of potential biopsy results including differences about high-risk and low-risk cancer, along with a treatment decision aid designed for men diagnosed with prostate cancer, or (2) usual care biopsy procedure instructions. The biopsy information was developed by study investigators and reviewed by clinicians, researchers, and cancer survivors from the Washington State Prostate Cancer Task Force; the decision aid was produced by the Michigan Cancer Consortium. A telephone interview was conducted prior to the biopsy date to assess the information’s perceived usefulness and effect on men’s knowledge about treatment options, as well as several indicators of the information’s impact on men’s quality of life, anxiety, and depression.
Results: A total of 55.6% of the 18 intervention subjects indicated the materials were very helpful compared to 18.2% of the 11 usual care subjects (p=0.05). Knowledge was improved among intervention subjects with 41.6% answering 14 items correctly compared to 32.5% (p=0.32). Overall quality of life assessed through a 100 point analog scale was significantly higher among intervention subjects 75.8 vs 48.5 (p<0.01). Anxiety related to prostate cancer was lower among intervention subjects compared to usual care subjects, 42.2 vs 51.7 (p=0.14). There were no significant differences in depressive symptoms using the PHQ8 among the intervention group compared to usual care 7.2 vs 9.0 (p=0.52).
Conclusions: Providing comprehensive information about the risks of prostate cancer treatment options to men who are undergoing a biopsy but do not yet know their cancer status improved general quality of life, lowered anxiety, and was perceived as very helpful. Offering treatment information prior to biopsy is an acceptable intervention and merits further study with a larger sample.
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