**2. Methods**

We surveyed patients who had been newly diagnosed with LPC (stages T1a to T2c) in the preceding 6 months, had met with their urologist after the diagnosis, were scheduled to receive treatment or observation, and had not yet been treated with surgery or radiation. Patients with dementia, or those who could not read, write, or understand English, were excluded. All patients were recruited from a large, private urology practice in Norfolk, Virginia. Staff at this practice systematically contacted patients newly diagnosed with LPC between March 2005 and November 2007 regarding their interest in participation in a selfadministered mailed survey. Two concomitant pretreatment self-administered surveys were used. The first survey asked patients about expectations of survival with and without treatment, co-morbid diseases, mood, social support, satisfaction with life, health, and education by physicians about treatment options. A list of health-related words in a closed envelope was mailed with the survey. Patients were requested to open the envelope and read these words on the telephone to a research assistant. This was done to estimate patient health literacy by using a brief version of the Rapid Estimation of Health Literacy in Medicine scale.14 Patients were given a \$10 stipend for completing this survey. A second pretreatment survey was a part of a longitudinal follow-up by urologists to evaluate generic HRQOL, prostate cancer related symptoms, and fear of cancer recurrence. The study methods were reviewed and approved by an Institutional Review Board.
