Many think cancer spreads by air

One in six prostate cancer patients believed that cancer can be spread by air, and that belief may affect their treatment choices, results of a patient survey showed. Men who believed that air can spread cancer were more than three times as likely not to choose radical prostatectomy as a treatment option, compared with men who said cancer definitely cannot be spread by air. The findings emphasize how physicians need to be sure that cancer patients understand the disease, particularly with respect to treatment options, Willie Underwood, MD, said here at the American Urological Association meeting. "If a patient is going to have surgery, he might ask, 'What are you going to do if the cancer has spread?'" said Underwood, of Roswell Park Cancer Institute in Buffalo, N.Y. "Physicians might think the patient is asking whether the cancer has spread to other sites in the body." "In fact, the patient might be asking, 'What are you going to do when you open me up and the air hits the cancer and spreads it?' We think that's what some patients are asking." The potential misunderstanding came to light in a survey of 158 patients with localized prostate cancer. The patients completed the questionnaire after they had made a treatment decision but before treatment had begun. The survey included a question about the patient's belief that air can spread cancer. Underwood said that 154 of the 158 patients answered the question. Analysis of survey responses showed that 25 (16.53%) men said air can spread cancer, and 50 (32.7%) others said they didn't know. A slim majority of the men (51%) said air definitely cannot spread cancer. Examination of demographic and clinical characteristics showed no difference in age, racial mix, income, PSA value, Gleason score, or treatment with external radiation therapy between men who said air can spread cancer and those who said it could not or weren't sure. Additionally, the men did not differ with respect to the quantity or type of patient education resources available to them, including pamphlets, friends, television, and journal articles. However, men who believed air can spread cancer were less educated (P=0.02), less likely to receive androgen suppression therapy (P=0.02), and less likely to choose radical prostatectomy as primary treatment. In a multivariate analysis, men who believed air can spread cancer had an odds ratio of 3.7 for not choosing radical prostatectomy as treatment, compared with men who believed air does not spread cancer or weren't sure. "A significant proportion of men with localized prostate cancer may believe that air spreads cancer," said Underwood. "Additionally, the opinion that air spreads cancer may influence the ultimate treatment decision-making." "In counseling men regarding prostate cancer treatment options, it is important to understand the influence of patients' attitudes and beliefs regarding the treatment options." As part of an ongoing study funded by the National Institutes of Health, investigators have enrolled 700 men, all of whom have completed a survey that includes questions about attitudes and beliefs about cancer. Underwood told MedPage Today that the survey questionnaire has undergone considerable revision as a result of information gained from responses to earlier versions. No timetable has been established for reporting additional data from the study. Primary source: American Urological Association