New Study Investigates Treatment-Associated Regrets In Prostate Cancer

When choosing treatment for prostate cancer, doctors can make recommendations, but they cannot decide for their patients.

You always have the final word and should make an informed choice about which treatment you select.

In cancer, radiotherapy, chemotherapy, and other treatment options are very difficult to endure. We should consider their side effects, and patients should never feel forced to accept a specific prostate cancer treatment.

Once you begin a cancer treatment plan, it’s crucial to understand that some side effects can be challenging to reverse. It’s essential to be well-informed about what to expect.

If you had a surgical procedure, you might need to engage in new treatments to solve complications and side effects.

All of this should be discussed in advance with your doctor before starting your prostate cancer treatment. And even after doing so, many patients regret their decisions, especially those who experience complications.

A new study investigates treatment-associated regrets in prostate cancer

Regretting the decision to start a given prostate cancer treatment is not a new concept in urologic oncology. However, a new study investigated the problem and how frequently it happens. The study suggests that regretting treatment decisions as a prostate cancer patient is more frequent than we think.

The study included 2,072 patients with cancer in the prostate gland who chose their treatment according to recommendations. Half of them had early-stage prostate cancer or low-risk prostate cancer. The other half had advanced prostate cancer or an intermediate severity. Depending on their condition, they received radiation therapy, radical prostatectomy, and other treatments.

The study aimed to ask these patients how they felt about their decision to undergo treatment. That way, researchers could determine the rate of treatment-associated regret. 

In other words, how frequently do patients feel regret for their treatment choices? The study also evaluated functional outcomes and the patient’s expectations of their treatment.

The patients’ average age was 64 years, and none of them were 80 years or older. They underwent three types of treatment. 

The most common was surgery, followed by radiation therapy and active surveillance. The study involved periodic questionnaires where patients provided feedback.

The questionnaires asked, among other things, if they felt that different treatment approaches would be better for them.


What the study found

The numbers in the clinical trial showed that a significant proportion of prostate cancer patients regret their treatment choices. 

They received surgery (16%), radiotherapy (11%), or active surveillance (7%), and 13% of the entire group had regrets about their decisions. 

This is a bit more than 1 in 10 patients, and regret was more common in active treatment (surgery and radiation therapy) than active surveillance. The most commonly affected group was the one that underwent surgery, namely radical prostatectomy.

Compared to 20 patients under active surveillance who felt regret of their decision, 76 felt regret after radiation treatment and 183 patients after radical prostatectomy. Only patients with aggressive disease (such as advanced prostate cancer or castration-resistant prostate cancer) did not regret receiving prompt treatment.

Sexual dysfunction was one of these patients’ top causes of regret. The investigation aimed not to find out which complications led to regret. However, this was reported as an extra piece of information. This could be why the highest incidence of regret was in patients receiving surgery. 

As for patients under active surveillance, the leading cause of regret was disease progression. Patients felt the problem would’ve been solved if they’d received another treatment option earlier.

After reporting their findings, the research group investigator Randy Jones, PhD., RN, mentioned that the main takeaway was that patients have an important discrepancy between their expectations and their actual experience. 

Make sure you understand the risks and implications, and have a realistic approach to the possible complications.

Future clinical trials could focus on the cause of regret to confirm these findings. They could also widen the research field to include other treatment options besides surgery, radiation therapy, and active surveillance.

RELATED: Ray’s Story Of How Different Prostate Cancer Treatments Impacted His and His Friends Quality of Life.

How some prostate cancer treatments affect your quality of life

Prostate cancer growth is usually slow, but some cases are dangerous and turn into metastatic prostate cancer. Thus, we recommend early prostate cancer screening if you have symptoms and/or risk factors, and learning about your treatment options (2).

But, remember that cancer treatment could also affect healthy tissue in an attempt to destroy prostate cancer cells. This is true in chemotherapy, radiotherapy, and surgery. 

For example, you could stretch the nerves that run along the prostate gland after a radical prostatectomy. Sometimes, they could be accidentally destroyed, even with a very careful surgical technique. As a result, you could experience sexual dysfunction

Radiation oncology treatments are an option for localized prostate cancer, but they affect the surrounding tissue, too. Side effects include pain, burns, rectal bleeding, and a temporary increase of urinary symptoms (3).

Prostate biopsies have significant side effects such as chronic rectal bleeding, burning urinary pain, urinary infections, and chronic pelvic pain. Thus, you should consider all of this and ponder the best treatment option for your cancer type (4).


Considerations when choosing your prostate cancer treatment

Not all patients are candidates for active surveillance and similar approaches. Many of them require active prostate cancer treatment. 

It can be overwhelming, and you may need to decide quickly if you have advanced prostate cancer.

In such cases, ensure that the treatment option you select aligns with your specific needs and circumstances.

Make sure that you fully understand what it takes and what you will feel throughout the process. If you’re receiving hormonal therapy, ask your doctor about your propensity for fractures, sexual dysfunction, and dyslipidemia. 

If you’re choosing radiation treatment, talk about the risks with the radiation oncologist, even if this is focal therapy. Before any prostate cancer surgery, ask your doctor about the risk associated with the procedure and the side effects. 

Ask if other types of surgery are available according to your cancer type. If you’re undergoing systemic therapy (as in chemotherapy), prepare yourself and your family for the changes to come.

Sometimes, doctors may push patients towards certain options. Remember that the decision is yours because you’re the only one going through the process and experiencing the side effects. 

If you ever have concerns or questions about a recommended treatment, don’t hesitate to seek a second opinion. Healthcare providers understand the importance of making informed decisions.

Ask yourself how many treatment options you know about. Remember that medicine has many new advances, and it is doubtful that you will only benefit from one or two approaches. 

Once you’re introduced to each treatment option available, ask every question that comes to mind. Write them down for later if you come up with questions outside the doctor’s office. Take your time to decide and make sure you’re reading from reliable sources if you do internet research.

Our Advanced Prostate Cancer Risk Assessment (APCRA)

Our Advanced Prostate Cancer Risk Assessment (APCRA) consists of non-invasive blood tests and specialized color Doppler scans to check whether you have prostate cancer. 

The variety and sophistication of some of these new blood tests make this a very realistic alternative to a prostate biopsy, especially if you have a preference for non-invasive diagnostics and treatments. 

After this testing, you will receive a thorough, 3-hour consultation from a Naturopathic Physician who is also a Professor of Urology and a very detailed, written report of your results to be discussed during the appointment.

He will walk you through the results of his assessment and explain every aspect and each option available to you, while also answering any questions that you may have. Your consultation will be like an educational mini-seminar about the real issues facing you as a patient.

Most urologists will have a preference for the particular treatment that they provide. However, the consultant you will see has no agenda and is entirely free to offer honest, independent advice

He will try and help with any information you need in order to arrive at your decision. But he will not try to sway you one way or the other. 

Aside from that, the greatest additional benefits of the APCRA are that it is non-invasive, does no damage, and does not close off any avenues for future treatment.

To book our Advanced Prostate Cancer Risk Assessment, please call our customer service team on +1-888-868-3554, who will be happy to assist you and offer any further information.


If you were diagnosed with cancer, it is essential to understand and have realistic expectations of your treatment options. Cancer in the prostate gland usually grows very slowly, but not always. 

The treatment your doctor recommends will depend on your age, risk factors, and cancer type. But regardless of the treatment recommended to you, it is essential to understand every aspect of it. Otherwise, you could regret your treatment choices, and once you’ve made a decision, it is sometimes difficult to turn back.

According to the new study reviewed in this article, a significant proportion of patients under active treatment (surgery, radiation therapy) experience regret and wish they requested a different approach. 

It also happens to a lesser degree in patients under active surveillance. The main reason is that the patient initially had a misconception about the treatment course, length, side effects, and possible complications.

Thus, it is undoubtedly important to consider the benefits of prostate cancer treatment as long as we weigh the pros and cons. Start by asking your doctor everything you need to know. 

Research from reputable sources and keep asking questions. Ask your doctor how long you have to make up your mind, take your time, and prepare yourself and your family for the upcoming life-changing events you may need to face together.

Explore More


Prostate Cancer: Coping, Support, and Living Well.


  1. Wallis, C. J., Zhao, Z., Huang, L. C., Penson, D. F., Koyama, T., Kaplan, S. H., … & Barocas, D. A. (2022). Association of treatment modality, functional outcomes, and baseline characteristics with treatment-related regret among men with localized prostate cancer. JAMA oncology, 8(1), 50-59. 
  2. Carroll, P. H., & Mohler, J. L. (2018). NCCN guidelines updates: prostate cancer and prostate cancer early detection. Journal of the National Comprehensive Cancer Network, 16(5S), 620-623. 
  3. Michaelson, M. D., Cotter, S. E., Gargollo, P. C., Zietman, A. L., Dahl, D. M., & Smith, M. R. (2008). Management of complications of prostate cancer treatment. CA: a cancer journal for clinicians, 58(4), 196-213. 
  4. Hübner, N., Shariat, S., & Remzi, M. (2018). Prostate biopsy: guidelines and evidence. Current opinion in urology, 28(4), 354-359. 

Top Products

Total Health


Glucose Control