Treatment decision making in prostate cancer: Patients’ participation in complex decisions

Abstract

Objective: (1) To explore to what degree prostate cancer (PC) patients felt they had participated in treatment decision making (TDM). (2) To determine whether perceived roles during TDM were associated with medical and sociodemographic variables. (3) To examine to what extent satisfaction with TDM was related to perceived role or medical and sociodemographic variables. Methods: Patients (n = 126) were recruited in hospitals and from the Dutch PC patient organization. The relationship between patients' role and stage of disease, treatment modality, age, social status and education was determined, as well as patients' satisfaction with TDM. Results: Most patients felt they had participated in TDM (autonomous 18%, collaborative 60%). Older patients and those with advanced disease more frequently reported not having been involved in decision making. Satisfaction with TDM was related to age and role in TDM but not to stage of disease or treatment modality. Younger men were least content when they had not been involved in decision making. Conclusion: Patients' level of participation and satisfaction with TDM appears to be related to medical and sociodemographic variables. Practice implications: Satisfaction with TDM may be related to patients' age and assumed role. It is recommended to take this into account when planning treatment for prostate cancer patients. #

Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM)

“…This preference for an active role, however, has not been consistently reflected in conventional treatment decision-making research. In fact, both women and men living with cancer have been found to prefer a collaborative decisionmaking role, in which patients and physicians work together in reaching treatment decisions [16,20,23,48]. Given the growing emphasis on shared decision making in cancer care [12], it is not surprising that the women in our study expected open discussions about CAM with their physicians.…”

Who makes the decision regarding the treatment of clinically localized prostate cancer–the patient or physician?

“…Compared with patients aged 65 years, younger men were more likely to engage in patient-only versus physician-only decision-making, a finding similar to that of previous studies. 33,34 Younger men may be more likely to seek information from different sources, 34 including consultation from 3 physicians. 35 These activities may better equip patients to make decisions on their own and/or to communicate with physicians regarding their needs and treatment preferences.…”

The decision-making role of the patient in localised prostate cancer treatment

“…(Figure 1) These include, 1 study examining influences of partners (Zeliadt, Penson et al 2011), 2 studies examining influence of physicians (Fowler, McNaughton Collins et al 2000, Stalmeier, van Tol-Geerdink et al 2007, 16 studies comparing treatment preferences (Mazur and Hickam 1996, Hall, Boyd et al 2003, Auvinen, Hakama et al 2004, Berry, Ellis et al 2006, Zeliadt, Ramsey et al 2006, Block, Erickson et al 2007, Cox and Amling 2008, van den Bergh, van Vugt et al 2010, Davison and Goldenberg 2011, Ihrig, Keller et al 2011, Hamilton, Wu et al 2012, Penson 2012, Sidana, Hernandez et al 2012, van TolGeerdink, Willem Leer et al 2013, 4 studies on decision aids (Lin, Aaronson et al 2009, Adsul, Wray et al 2015, Violette, Agoritsas et al 2015, van Tol-Geerdink, Leer et al 2016, 7 studies (Cohen and Britten 2003, Davison, Goldenberg et al 2003, Davison, Parker et al 2004, Fischer, Visser et al 2006, Deber, Kraetschmer et al 2007, Pieterse, Henselmans et al 2011, Song, Chen et al 2013, 4 studies related to psychosocial issues of decision making (Wong, Stewart et al 2000, Kraetschmer, Sharpe et al 2004, Steginga, Turner et al 2008, Birnie and Robinson 2010, 3 studies on demographic differences in decision making (Meyer, Talbot et al 2007, Xu, Dailey et...…”

“…Percentage of patients choosing radical prostatectomy have been quoted to be between 29-81.4%; 10.7 -42% of patients elected to have radiation treatment and rate of active surveillance has been reported up to 42% (Mazur and Hickam 1996, Hall, Boyd et al 2003, Fischer, Visser et al 2006, Ihrig, Keller et al 2011, Sidana, Hernandez et al 2012.…”

“…They must consider a number of factors such as evidence for treatment efficacy, differing profiles of short and long-term side effects, inputs from physicians, family members, or friends, economic consequences, prior medical care experiences, as well as other influencing factors (Zeliadt, Ramsey et al 2006). decision making, defined as a process of engagement in which physician and the patient work together, with available information, to understand the clinical issues and determine the best management options; 3) a passive role of the patient implies that the physician reviews the options and makes the decision on behalf of the patient (Fischer, Visser et al 2006). In clinical setting, the decision making process is often affected by time and resource constraints, severity of illness and limitation of treatment options (O'Grady, Jadad 2010).…”