Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany


Purpose: Many studies demonstrate the importance of an empathic communication with prostate cancer patients and show various information needs. Most of the studies are cross sectional. The present analysis aims to 1) provide detailed prospective data on the actual quality of patient information provided by urologists in private practice in Germany; and 2) explore sociodemographic, communicative, and health- and treatment related determinants of the quality of provider-patient-communication. Methods: HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, patient reported outcomes and patients’ assessment of patient-physician-communication are documented. A total of 1893 questionnaires at t0 (initial diagnosis) and t1 (six months after diagnosis) were analyzed. A linear regression model was estimated. Results: The mean age of the men was 68.38 years, and most lived with their spouse or partner (94.1%). Most patients were informed about treatment options (t0 96%, t1 93.2%), but much fewer received information about self-help groups (t0 36.4%, t1 45.8%), rehabilitation (t0 59.9%, t1 68%), and second medical opinion (t0 57.2%, t1 59.3%). Older men (p = 0.02) and men living alone (p = 0.048) received less information than others. Physician empathy (p = 0.000) and prostatectomy treatment (p = 0.020) were positively associated with receiving more information. Conclusion: There is room for improvement in terms of informing prostate cancer patients about rehabilitation, second medical opinion and self-help groups. Urologists being empathetic share more information with their patients. Some patients receive less information than others, especially older patients living alone.

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J. Jaeger, L. Weißbach, H. Pfaff and N. Ernstmann, "Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany," Journal of Cancer Therapy, Vol. 4 No. 4A, 2013, pp. 3-10. doi: 10.4236/jct.2013.44A002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] G. Husmann, P. Kaatsch, A. Katalinic, J. Bertz, J. Haberland and K. Kraywinkel, “Krebs in Deutschland 2005/ 2006. H?ufigkeiten und Trends. 7. Ausgabe,” Robert KochInstitut und Die Gesellschaft der Epidemiologischen Krebsregister in Deutschland ev. (Hrg.), Vol. 7, 2010. http://www.krebsgesells chaft.de/download/KID2010.pdf
[2] American Cancer Society, “Cancer Facts & Figures 2012,” American Cancer Society, Atlanta, 2012, pp. 19-20. http://www.cancer.org/research/cancerfactsfigures/cancerfactsfigures/cancer-facts-figures-2012
[3] V. Rhode, A. Katalinic and J. Wasem, “Gesundheitsberichterstattung des Bundes Heft 36: Prostataerkrankungen,” Robert Koch Institut (Hrsg.), Berlin, 2007. http://edoc.rki.de/documents/ rki_fv/ren4T3cctjHcA/ PDF/20Vo4CXYDBpeQ_34.pdf
[4] S. R. Epstein and R. M. Street Jr., “Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering,” National Cancer Institute, Bethesda, 2007.
[5] T. Hack, L. Degner and P. Parker, “The Communication Goals and Needs of Cancer Patients: A Review,” PsychoOncology, Vol. 14, No. 10, 2005, pp. 831-845; Discussion 846-847. doi:10.1002/pon.949
[6] B. Davison, S. Goldenberg, M. Gleave and L. Degner, “Provision of Individualized Information to Men and Their Partners to Facilitate Treatment Decision Making In Prostate Cancer,” Oncology Nursing Forum, Vol. 30, No. 1, 2003, pp. 107-114. doi:10.1188/03.ONF.107-114
[7] C. K. Gwede, J. Pow-Sang, J. Seigne, R. Heysek, M. Helal, K. Shade, A. Cantor and P. B. Jacobsen, “Treatment Decision-Making Strategies and Influences in Patients with Localized Prostate Carcinoma,” Cancer, Vol. 104, No. 7, 2005, pp. 1381-1390. doi:10.1002/cncr.21330
[8] J. Huber, A. Ihrig, C. G. Huber, B. Hadaschik, S. Pahernik and M. Hohenfellner, “Patientenorientierung und Entscheidungsfindung bei Lokal Begrenztem Prostatakarzinom,” Der Urologe, Vol. 50, No. 6, 2011, pp. 691-696. doi:10.1007/s00120-011-2587-6
[9] S. Steginga, E. Turner and J. Donovan, “The DecisionRelated Psychosocial Concerns of Men with Localised Prostate Cancer: Targets for Intervention and Research,” World Journal of Urology, Vol. 26, No. 5, 2008, pp. 469-474. doi:10.1007/s00345-008-0279-7
[10] H. Cohen and N. Britten, “Who Decides about Prostate Cancer Treatment? A Qualitative Study,” Family Practice, Vol. 20, No. 6, 2003, pp. 724-729. doi:10.1093/fampra/cmg617
[11] F. Fang, N. Keating, L. Mucci, H.-O. Adami, M. Stampfer, U. Valdimarsdottir and K. Fall, “Immediate Risk of Suicide and Cardiovascular Death after a Prostate Cancer Diagnosis: Cohort Study in the United States,” Journal of the National Cancer Institute, Vol. 102, No. 5, 2010 pp. 307-314. doi:10.1093/jnci/djp537
[12] V. Nanton, A. Docherty, C. Meystre and J. Dale, “Finding a Pathway: Information and Uncertainty along the Prostate Cancer Patient Journey,” British Journal of Health Psychology, Vol. 14, Pt. 3, 2009, pp. 437-458. doi:10.1348/135910708X342890
[13] N. Davies, G. Kinman, R. Thomas and T. Bailey, “Information Satisfaction in Breast and Prostate Cancer Patients: Implications for Quality of Life,” Psycho-Oncology, Vol. 17, No. 10, 2008, pp. 1048-1052. doi:10.1002/pon.1305
[14] D. Feldman-Stewart, M. D. Brundage, C. Hayter, P. Groome, J. C. Nickel, H. Downes and W. J. Mackillop, “What Questions Do Patients with Curable Prostate Cancer Want Answered?” Medical Decision Making, Vol. 20, No. 1, 2000, pp. 7-19. doi:10.1177/0272989X0002000102
[15] D. Feldman-Stewart, S. Brennenstuhl, M. D. Brundage and D. R. Siemens, “Overall Information Needs of EarlyStage Prostate Cancer Patients over a Decade: Highly Variable and Remarkably Stable,” Supportive Care in Cancer, Vol. 17, No. 4, 2009, pp. 429-435. doi:10.1007/s00520-008-0514-1
[16] D. Feldman-Stewart, C. Capirci, S. Brennenstuhl, C. Tong, U. Abacioglu, M. Gawkowska-Suwinska, F. van Gils, A. Heyda, S. Igdem, V. Macias, I. M. Grillo, C. Moynihan, M. Pijls-Johannesma, C. Parker, N. Pimentel and H. Wordehoff, “Information Needs of Early-Stage Prostate Cancer Patients: A Comparison of Nine Countries,” Radiotherapy and Oncology, Vol. 94, No. 3, 2010, pp. 328-333. doi:10.1016/j.radonc.2009.12.038
[17] R. Schaffert, P. Ruesch, R. Gugler, S. Fischer, H.-P. Schmid, P. Sporri, M. Zurkirchen and R. Ruszat, “Informationsbedurfnisse von Prostatakrebspatienten. Grosse Individuelle Unterschiede nach Diagnose eines Lokalisierten Prostatakarzinoms,” Der Urologe, Vol. 50, No. 9, 2011, pp. 1089-1094. doi:10.1007/s00120-011-2626-3
[18] E. W. Boberg, D. H. Gustafson, R. P. Hawkins, K. P. Offord, C. Koch, K. Y. Wen, K. Kreutz and A. Salner, “Assessing the Unmet Information, Support and Care Delivery Needs of Men with Prostate Cancer,” Patient Education and Counseling, Vol. 49, No. 3, 2003, pp. 233-242. doi:10.1016/S0738-3991(02)00183-0
[19] J. Hall, J. Boyd, M. Lippert and D. Theodorescu, “Why Patients Choose Prostatectomy or Brachytherapy for Localized Prostate Cancer: Results of a Descriptive Survey,” Urology, Vol. 61, No. 2, 2003, pp. 402-407. doi:10.1016/S0090-4295(02)02162-3
[20] S. K. Steginga, S. Occhipinti, R. A. Gardiner, J. Yaxley and P. Heathcote, “Making Decisions about Treatment for Localized Prostate Cancer,” BJU International, Vol. 89, No. 3, 2002, pp. 255-260. doi:10.1046/j.1464-4096.2001.01741.x
[21] E. S. Holmboe and J. Concato, “Treatment Decisions for Localized Prostate Cancer: Asking Men What’s Important,” Journal of General Internal Medicine, Vol. 15, No. 10, 2000, pp. 694-701. doi:10.1046/j.1525-1497.2000.90842.x
[22] D. Feldman-Stewart, M. D. Brundage, C. Hayter, P. Groome, J. C. Nickel, H. Downes and W. J. Mackillop, “What Prostate Cancer Patients Should Know: Variation in Professionals’ Opinions,” Radiotherapy and Oncology, Vol. 49, No. 2, 1998, pp. 111-123. doi:10.1016/S0167-8140(98)00091-7
[23] D. Cegala, R. Bahnson, S. Clinton, P. David, M. Gong, J. R. Monk, S. Nag and K. S. Pohar, “Information Seeking and Satisfaction with Physician-Patient Communication among Prostate Cancer Survivors,” Health Communication, Vol. 23, No. 1, 2008, pp. 62-69. doi:10.1080/10410230701806982
[24] R. E. Gray, L. H. Klotz, N. A. Iscoe, M. I. Fitch, E. Franssen, B. J. Johnson and M. M. Labrecque, “Prostate Cancer Patients’ Satisfaction with Medical Information,” The Canadian Journal of Urology, Vol. 4, No. 2, 1997, pp. 83-87.
[25] S. McGregor, “What Information Patients with Localised Prostate Cancer Hear and Understand,” Patient Education and Counseling, Vol. 49, No. 3, 2003, pp. 273-278. doi:10.1016/S0738-3991(02)00182-9
[26] S. Snow, R. Panton, L. Butler, D. Wilke, R. Rutledge, D. Bell and R. A. Rendon, “Incomplete and Inconsistent Information Provided to Men Making Decisions for Treatment of Early-Stage Prostate Cancer,” Urology, Vol. 69, No. 5, 2007, pp. 941-945. doi:10.1016/j.urology.2007.01.027
[27] D.-H. Zermann, “Der Patient nach Radikaler Prostatektomie,” Der Urologe, Vol. 50, No. 4, 2011, pp. 425-432. doi:10.1007/s00120-010-2481-7
[28] B. Bestmann, T. Kollakowski and L. Weissbach, “Lebensqualitat nach Prostatakarzinom bei Teilnehmern von Selbsthilfegruppen,” Der Urologe, Vol. 50, No. 3, 2011, pp. 333-339. doi:10.1007/s00120-010-2491-5
[29] D. Katz, T. Koppie, D. Wu, M. Meng, G. Grossfeld, N. Sadesky, D. P. Lubeck and P. R. Carroll, “Sociodemographic Characteristics and Health Related Quality of Life in Men Attending Prostate Cancer Support Groups,” The Journal of Urology, Vol. 168, No. 5, 2002, pp. 2092-2096. doi:10.1016/S0022-5347(05)64303-0
[30] I. Gregoire, D. Kalogeropoulos and J. Corcos, “The Effectiveness of a Professionally Led Support Group for Men with Prostate Cancer,” Urologic Nursing, Vol. 17, No. 2, 1997, pp. 58-66.
[31] N. Ernstmann, O. Ommen, C. Kowalski, M. Neumann, A. Visser, H. Pfaff and L. Weissbach, “A Longitudinal Study of Changes in Provider-Patient Interaction in Treatment of Localized Prostate Cancer,” Support Care Cancer, Vol. 20, No. 4, 2012, pp. 791-797. doi:10.1007/s00520-011-1151-7
[32] N. K. Aaronson, S. Ahmedzai, B. Bergman, M. Bullinger, A. Cull, N. J. Duez, A. Filiberti, H. Flechtner, S. B. Fleishman and J. C. Haes, “The European Organization for Research and Treatment of Cancer QLQ-C30: A Qualityof-Life Instrument for Use in International Clinical Trials in Oncology,” Journal of the National Cancer Institute, Vol. 85, No. 5, 1993, pp. 365-376. doi:10.1093/jnci/85.5.365
[33] R. Schwarz and A. Hinz, “Reference Data for the Quality of Life Questionnaire EORTC QLQ-C30 in the General German Population,” European Journal of Cancer, Vol. 37, No. 11, 2001, pp. 1345-1351. doi:10.1016/S0959-8049(00)00447-0
[34] M. Neumann, M. Wirtz, E. Bollschweiler, M. Warm, J. Wolf and H. Pfaff, “Psychometrische Evaluation der Deutschen Version des Messinstruments ‘Consultation and Relational Empathy’ (CARE) am Beispiel von Krebspatienten,” Psychotherapie, Psychosomatik, Medizinische Psychologie, Vol. 58, No. 1, 2008, pp. 5-15. doi:10.1055/s-2007-970791
[35] S. Steginga, D. Smith, C. Pinnock, R. Metcalfe, R. Gardiner and J. Dunn, “Clinicians’ Attitudes to Prostate Cancer Peer-Support Groups,” BJU International, Vol. 99, No. 1, 2007, pp. 68-71. doi:10.1111/j.1464-410X.2006.06545.x
[36] A. Robinson and R. Thomson, “Variability in Patient Preferences for Participating in Medical Decision Making: Implication for the Use of Decision Support Tools,” Quality in Health Care: QHC, Vol. 10, Suppl. 1, 2001, pp. i34-i38. doi:10.1136/qhc.0100034
[37] A. Moreau, L. Carol, M. C. Dedianne, C. Dupraz, C. Perdrix, X. Laine and G. Soweine, “What Perceptions Do Patients Have of Decision Making (DM)? Toward an Integrative Patient-Centered Care Model. A Qualitative Study Using Focus-Group Interviews,” Patient Education and Counseling, Vol. 87, No. 2, 2012, pp. 206-211. doi:10.1016/ j.pec.2011.08.010
[38] S. B. Zeliadt, S. D. Ramsey, D. F. Penson, I. J. Hall, D. U. Ekwueme, L. Stroud and J. W. Lee, “Why Do Men Choose One Treatment over Another?: A Review of Patient Decision Making for Localized Prostate Cancer,” Cancer, Vol. 106, No. 9, 2006, pp. 1865-1874. doi:10.1002/cncr.21822

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