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Helping Low-Literacy Prostate Cancer Patients Choose Rx

Helping Low-Literacy Prostate Cancer Patients Choose Rx

Prostate cancer represents the most common neoplasm and second leading cause
of cancer mortality among men in the United States. There are 189,000 new cases
of prostate cancer and 32,000 deaths resulting from prostate cancer expected in
2002.[1]

There is no particular prostate cancer treatment that is clearly superior
with respect to survival. As a result, patients and physicians should consider
the quality of life implications of each treatment during the decision-making
process.

Previous studies have suggested that physicians may experience difficulty
incorporating patient preferences into clinical decisions.

First, physicians and patients may have different ideas with respect to the
goals of treatment. Crawford found that patients rated preservation of quality
of life (45%) and extension of life (29%) as the most important treatment
goals, while urologists cited treatment efficacy (85%) as the primary
consideration in decision-making, ranking quality of life concerns as
secondary.[2] In the context of patient-physician communication, Miles found
that a majority of patients did not recall discussions with their treating
physicians about issues such as expectant management, patient preferences, and
treatment-related side effects.[3]

These studies suggest that physician understanding of patient concerns and
patient participation in the decision-making process should be addressed.

Works in Progress

Although patient involvement in the treatment decision-making process has
been encouraged, shared decision-making between patients and their physicians
and the programs used to increase patient participation remain works in
progress. A wide variety of shared decision-making programs, including videos,
brochures, and CD-ROMs, have been developed to provide patients with
information about prostate cancer and the risks and benefits associated with
each treatment option.

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