Sandra McGregor

What information patients with localised prostate cancer hear and understand

Patients with localised prostate cancer can decide on a treatment option that is appropriate for their needs and lifestyle only if their doctor provides information that they understand and can remember. This small study (n10) examined the knowledge of men who had been diagnosed but had not been treated for early stage disease. A semi-structured interview schedule enabled these men to demonstrate their knowledge of their disease and its treatment. They were aware that they had incomplete understanding, but no one asked that information should be provided until, and in a language, they understood. Only two men felt that the choice of treatment belonged to them, others agreed with the decision of their urologist although they did not understand why a specific treatment was recommended or the implications of that treatment.

Information on video format can help patients with localised prostate cancer to be partners in decision making

A video was produced to inform men diagnosed with localised prostate cancer of the different management options for their disease. It was tested for increased knowledge and understanding on a healthy population of similar age (n=10), who were assessed before and after watching the video (20 interviews). The video was then shown to 12 men who had been diagnosed with prostate cancer but had not started any treatment for their disease (24 interviews). Interviews among the healthy cohort revealed not only the lack of knowledge of anatomy and physiology but also the way in which these men used past experiences to help explain and remember complex medical procedures. The patients focused on the treatments and outcomes, remembering less of the technicalities. All men interviewed vividly remembered the patients participating in the video; they drew inferences and developed affinity towards specific individuals. Both groups felt that video provided information in a user friendly way. Although remembering few anatomical terms all participants described a visual image that led to a perception of understanding rather than a definitive increase in knowledge. Patients, however, felt they had a clearer understanding of the disease and its treatment, and therefore better able to be active informed partners in the decision-making process.

Does writing a list help cancer patients ask relevant questions

We examined the use of written lists to give patients an opportunity to have their questions answered. Patients undergoing radical radiotherapy for cancer were given a sheet of paper with the simple prompt to write questions and give to the hospital doctor at their appointment 3 weeks later. At 3 months, patients were asked about their use and opinions of the written list. About half of the 478 patients attended with a written list. Fewer patients living in deprived areas used the list compared to more affluent areas. Doctors thought that 34% of patients would not otherwise have asked those questions and 91% of prompted discussions were a worthwhile use of time.