Questionnaire for Prostate Cancer

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  • Topic: Prostate cancer, Radiation therapy, Cancer
  • Pages : 2 (277 words )
  • Download(s) : 45
  • Published : January 17, 2011
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NAME (OPTIONAL): ____________________AGE: _____
COURSE: ____________________YEAR: ______
1. Are you familiar about the disease called Prostate Cancer? __ Very familiar__ Unfamiliar
__ Moderately familiar__ I don’t care

2. Is it important to have knowledge about Prostate Cancer? __ Strongly agree__ Disagree
__ Agree__ Strongly disagree
__ Not really

3. Where did you get information about the disease?
__Television__ Books__ Knowledgeable people
__ Radio__ InternetOther answer: ____________

4. In what age, males are affected by Prostate Cancer?
__ 13-19 yrs. old__ 51-79 yrs. old
__ 20-50 yrs. old__ 80 and above

5. What do you think is the cause of Prostate Cancer?
__ Age__ Family history
__ Ethnic groupOther answer: ____________
__ Unhealthy Diet

6. What is/are the symptom/s of having Prostate Cancer?
__ Trace of blood in the urine__Back or Pelvic pain
__Weight loss Other answer: ____________

7. Do you agree that Prostate Cancer can be prevented?
__ Strongly agree__ Disagree
__ Agree__ Strongly disagree
__ Moderately agree

8. What should you do if you have Prostate Cancer?
__ See the doctor__ Just ignore it
__ Undergo therapies Other answer: ____________
__ Exercise daily

9. What kind of treatment would you consider to be best for Prostate Cancer? __ Hormonal therapy
__ Radical prostatectomy
__ External-beam radiation therapy
__ Brachytherapy (internal or implanted radiation)
__ Other answer: ____________

10. In your opinion, how can Chemotherapy medicines, such as docetaxel (Taxotere) help men with Prostate Cancer? __ Prolong the survival of some patients
__ Decrease the pain related to widespread cancer
__ Other answer: ____________
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