A new tool may help make decisions less emotional for patients with low-risk prostate cancer and encourage patient-physician communication, according to results published in the Journal of Cancer Education.
While most patients with low-risk prostate cancer are more likely to die of other diseases than from their cancer, most still elect to receive aggressive treatment rather than begin active surveillance, where cancer is not immediately treated, but monitored closely for changes in pathology.
To help patients make more informed decisions about their care, researchers at Thomas Jefferson University (Philadelphia, PA) created the Decision Counseling Program, a support tool used by a trained nurse educator to help patients understand their options and identify the treatment choice that most meets their needs.
To test the effectiveness of the tool, researchers recruited 30 patients with localized, low-risk prostate cancer who were candidates for active surveillance. They then assessed their change in treatment knowledge, decisional conflict, and perceptions and identified predictors of active surveillance. Overall, they found that after using the tool, patients exhibited increased knowledge, decreased decisional conflict, and more favorable perceptions of active surveillance. Additionally, the majority of patients (n=25 [85%]) made the decision to initiate active surveillance rather than elect to receive aggressive therapy.
Authors noted that the utility of the tool lies in the autonomy it gives to the patient, allowing them to participate more actively and with greater understanding in the decisions surrounding their care.
“The power in the approach is that it gives the patient time to consider the options, put personal thoughts and concerns on the table, and have a voice in the decision making process,” said corresponding author Amy Leader PH, MPH, Assistant Professor of Medical Oncology and researcher at the Sidney Kimmel Cancer Center at Jefferson.
They concluded that the Decision Counseling Program succeeded at reducing the stress of decision-making surrounding treatment for prostate cancer in patients with low-risk disease. They added the tool could conceivably be duplicated for use in any disease state where decision-making is complicated and uncertain.
