What do men with metastatic prostate cancer consider when making treatment decisions? A mixed-methods study

Laura B. Oswald, Frank A. Schumacher, Brian D. Gonzalez, Kelvin A. Moses, David F. Penson, Alicia K. Morgans*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: Metastatic prostate cancer (mPCa) patients often make complicated treatment decisions, yet decision aids to facilitate shared decision-making for mPCa are uncommon. To inform the development of patient-centered mPCa decision aids, we examined what mPCa survivors considered most important when making treatment decisions. Methods: Using an exploratory sequential approach, we conducted three focus groups with 14 advanced prostate cancer survivors (n=5, n=3, n=6 in each group) to identify considerations for making treatment decisions. Focus groups were audio-recorded and transcribed, and we identified qualitative themes. We then developed a quantitative survey to assess the importance of each theme and administered the survey to mPCa survivors (N=100). We used relative frequencies to determine the most strongly endorsed items and chi-squared and Fisher’s exact tests to assess associations with participant characteristics. Results: Focus groups yielded 11 themes, and the resulting survey included 20 items. The most strongly endorsed mPCa treatment considerations were: relying on physician’s treatment recommendations (79% strongly agree); wanting to feel well enough to spend quality time with loved ones (72% strongly agree); the importance of dying in a manner consistent with one’s wishes (70% strongly agree); hoping to eliminate cancer completely (68% strongly agree); and optimizing treatment efficacy (65% strongly agree). Age, race, marital status, employment status, and self-reported health were related to how strongly men endorsed various considerations for mPCa treatment decision-making. Conclusion: We identified multiple considerations that mPCa survivors appraised when making treatment decisions. These data may inform the development of patient-centered decision aids for mPCa.

Original languageEnglish (US)
Pages (from-to)1949-1959
Number of pages11
JournalPatient Preference and Adherence
StatePublished - 2020


  • Decision-making
  • Focus groups
  • Metastasis
  • Prostate cancer
  • Quality of life

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy
  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)


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