Prostate cancer patients with cardiovascular disease were 52 per cent more likely to regret their treatment choices than men without problems with their heart or veins, according to a study published in the July issue of the urology journal BJUI International.
Research led by Harvard Medical School, USA, looked at 795 men with recurrent cancer in the Comprehensive Observational Multicenter Prostate Adenocarcinoma (COMPARE) registry.
"Treatment regret can have an adverse impact on a patient's overall outlook and has been associated with a poorer global quality of life" says lead author Dr Paul L Nguyen from the Department of Radiation Oncology at Harvard's Dana Farber Cancer Institute and Brigham and Women's Hospital.
"Understanding predictors of regret can help clinicians better counsel patients about their treatments so that later regret can be avoided."
Key findings of the study included:
"Most men with localised prostate cancer have multiple treatment options, each with their own set of potential risks and benefits" says Dr Nguyen. "While many patients are grateful for the chance to select their treatment, some may subsequently regret their treatment if the outcomes after therapy do not meet their expectations.
"Our study found that, among men with recurrent prostate cancer, those with cardiovascular health issues were 52 per cent more likely to regret their treatment choice than men without cardiovascular problems. It highlights the growing importance of considering other health issues such as cardiovascular disease when counseling patients about prostate cancer treatment options.
"The clinical implication of the present study is that it provides another rationale for patients with cardiovascular problems and prostate cancer to consider active surveillance, which aims to avoid or delay unnecessary treatment in men with less aggressive cancers. This is because the potential benefit of treatment is relatively small for men with a short life expectancy and the potential for regret is significantly higher.
"Our research also suggests that prostate cancer patients with cardiovascular issues should be alerted to the potential increased risk of post-treatment toxicity, such as bowel problems, as this may help to reduce treatment regret if their cancer returns."