Program eases surveillance vs. treatment decision

When the pros and cons of prostate cancer treatment are spelled out using an online interactive program, more patients choose active surveillance over definitive treatment, according to researchers from Thomas Jefferson University in Philadelphia who developed the program.

To ensure that patients make their treatment decisions based on the most current medical evidence and their own values and preferences, researchers led by Ronald E. Myers, PhD, created the Decision Counseling Program to help patients clarify their treatment preference and discuss their options with the clinical team. The online program is unique to Thomas Jefferson University.

First, patients are shown a printed summary of answers to frequently asked questions by treatment type. Some of the questions include: “What treatment option is best for long-term survival?” and “What are the side effects?”

With the help of a nurse, the patient then identifies the top three reasons he may or may not want to initiate active surveillance (pros and cons). The patient then ranks those reasons by importance. The nurse enters the reasons and rankings into the online program and generates a one-page summary report that helps patients visualize their preference to active surveillance versus aggressive treatment.

A copy of the report is given to the patient and the clinical team. The report is used as a point of discussion during the patient’s clinical visit with a urologist and radiologist.

The research team tested the Decision Counseling Program with 23 low-risk prostate cancer patients. After participating in the program and speaking with the clinical team, 83% of the patients decided on active surveillance rather than aggressive treatment.

“Patients were more knowledgeable and reported feeling more informed, more supported, and less conflicted in their decision after going through the program,” Dr. Myers said. “They understood their options better, and felt like they were making a treatment decision that was right for them.”

Study data were presented at the Society for Medical Decision Making annual meeting in Baltimore.

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