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.
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. 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.
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.