13 November 2025

Making Informed Decisions and Managing Regret After Prostate Cancer Treatment

A prostate cancer diagnosis and life during and after treatments can feel overwhelming. Alongside the shock of a diagnosis, you may be faced with multiple treatment options and asked to make a choice—surgery, radiation therapy, brachytherapy, hormone therapy, or active surveillance. Each has similar rates of success for localised disease but different in the way they are delivered, and in side effect profile and lifestyle impact. Making the right decision for you is important for your ongoing physical health and emotional well-being, and can lead to less regret in the years after diagnosis.

Why Decision Regret Happens

Decision regret is sometimes described as the distress felt when comparing the outcomes of your chosen treatment with what might have happened had you chosen a different treatment pathway. Research shows 10–30% of men experience regret after prostate cancer treatment. Many men with prostate cancer are faced with deciding between treatment options that they didn’t expect to have to make, and they begin to question whether they made the right decision as time passes and circumstances change.

Men diagnosed with prostate cancer may initially have no symptoms and a good quality of life. With prostate cancer, they need to make a decision, which is not the case in many other cancers, where there may be one treatment option or a plan for multiple treatments rather than a choice between two or three.

In general, a long life expectancy for many men after treatment may mean regret can persist for years. One long-term study found 12% of men reported decision regret nearly two decades after surgery, with depression and low quality of life as strong predictors.

Common triggers for decision regret include:

  • Treatment Side effects: loss of urinary control, changes in sexual function, worsening bowel or urinary function
  • Feeling less masculine: feeling changes in physical function, body image and self-worth as a result of post-treatment changes
  • Unexpected changes in your recovery and cancer outcome: experiencing cancer recurrence or rising PSA levels- some men feel their choice of treatment failed to deliver a cure
  • Poor understanding of options: Many men feel the need to make a rushed decision out of fear that the cancer is progressing and choose the first option presented to them without asking whether other options are available.

Steps to Make an Informed Decision

Choosing the right prostate cancer treatment option for you does not need to be rushed. Prostate cancer is generally slow growing, and there is time to explore your options and choose the treatment that most suits your preferences and personal circumstances. Research shows that being involved, asking questions, taking time to understand options and making an informed decision leads to much lower decision regret over time.

  1. Know your options and side effects

Could you ask questions about your treatment options and how and where the treatment will take place? Take time to understand not just the side effects, but how they can be managed and how best to prepare for your treatment. Read the information provided, make a list of questions and seek answers from trusted health professionals.

  1. Clarify your priorities

Think about your goals and priorities in life.

Is preserving sexual function most important? Minimising hospital time or reducing impact on your work? What are the next options if prostate cancer re-occurs? Your answers may guide your choice.

  1. Engage in shared decision-making

When men feel involved in decisions, regret drops significantly. Could you ask your doctor about all options, risks, and recovery expectations? Many men also take into account their partner's or family's perspectives  and/or find it useful to talk to a trusted friend or another man who’s been through a particular treatment type. Others find attending a support group helpful. In all cases,  speaking with a prostate cancer specialist nurse is available through the PCFA Telenursing Service.

  1. Prepare for side effects

Please take a look at how you can prepare for and manage any potential side effects. For example, learning Pelvic floor exercises before surgery, adjusting your diet for improved bowel function, starting a tailored, structured exercise program while on hormone therapy, and seeking early sexual rehabilitation can all improve outcomes and reduce regret.

  1. Seek credible resources

Speak to a specialist nurse through the PCFA Telenursing service. Avoid “Dr Google” and Stick to credible websites like pcfa.org.au and prostate.org.au, which offer evidence-based guides, support groups, and specialist nurse services.

If you are struggling to make a decision, write a list of pros and cons for each treatment type, rate or weight these options against your values and priorities, and consider discussing them with a member of PCFA’s telenursing and counselling team to clarify and talk through your difficult decision.

Managing Regret If It Happens

Even with careful thought and planning, regret can occur. Coping can be hard and is often worsened by anxiety and depression. These strategies can be helpful:

  • Acknowledge your feelings: Regret is common and does not mean you made a “wrong” choice. You often made the best possible decision you could have in a stressful, difficult time.
  • Focus on what you can control: Rehabilitation, healthy lifestyle, and mental health support can improve quality of life.
  • Connect with others: There are many ways to understand and approach problems; knowing you are not alone or isolated can be helpful. Support groups come in many forms; monthly face-to-face groups are all over the country, and some meet virtually. PCFA offers an Online community forum and Facebook connections where people share their experiences, provide reassurance, and offer practical tips.
  • Consider professional help: Psychologists and counsellors can help manage Heightened distress and/or anxiety and depression, which can often amplify decision regret. Psychologists and counsellors can help you understand your situation and tailor decision-making and coping strategies to your circumstances. PCFA’s Telenursing and Counselling team offer a listening ear and evidence-based information and support as you navigate your treatment choices and other health-related decisions. 

Key Takeaways

  • Take time to understand your treatment options and their potential impact on your life.
  • Involve your partner or a trusted friend and your healthcare team in decision-making.
  • Use trusted resources and psychological strategies to reduce regret.
  • If regret arises, seek support—physical and emotional recovery is possible.

References:

Chambers, S. (20). Facing the Tiger: A Guide for Men with Prostate Cancer and the People Who Love Them.

Fanshawe, J. B., Wai-Shun Chan, V., Asif, A., Ng, A., Van Hemelrijck, M., Cathcart, P., Challacombe, B., Brown, C., Popert, R., Elhage, O., Ahmed, K., Brunckhorst, O., & Dasgupta, P. (2023). Decision Regret in Patients with Localised Prostate Cancer: A Systematic Review and Meta-analysis. European Urology Oncology, 6(5), 456–466. https://doi.org/10.1016/j.euo.2023.02.005

Lunger, L., Meissner, V.H., Kopp, B.C.G. et al. Prevalence and determinants of decision regret in long-term prostate cancer survivors following radical prostatectomy. BMC Urol 23, 139 (2023). https://doi.org/10.1186/s12894-023-01311-9

Mail, R.D. et al Long-Term Decision Regret Among Patients with Localised Prostate Cancer: Results from a Population-Based Cohort, International Journal of Radiation Oncology, Biology, Physics, Volume 123, Issue 1, S64 (2025)

Targeting Cancer: Informed Decision Making in the Management of Localised Prostate Cancer Faculty of Radiation Oncology Position Statement  Version Approved 2018. Accessed online https://www.ranzcr.com/college/document-library/informed-decision-making-in-the-management-of-localised-prostate-cancer-position-paper

Whether you’re a patient, a family member, or would like more information about prostate cancer, we’re here to support you. 

Connecting with a Prostate Cancer Specialist Telenurse is easy. Please submit this form below or call us on 1800 22 00 99.

Further resources:

Prostate Cancer Foundation of Australia: pcfa.org.au
https://www.pcfa.org.au/news-media/news/treatment-decision-regret/
https://www.facebook.com/groups/pcsgs
https://community.prostate.org.au