Receiving a diagnosis of prostate cancer can be frightening, and in order to better deal with the stress of the disease, there is a new trend for patients to be more involved in the choice of treatment. Despite the benefits from a discussion between patient and physician when it comes to therapeutic options, researchers from the Helsinki University Hospital noted that this collaboration requires understanding both treatments and personal situations.
The idea that patients’ thoughts and feelings are important for the choice of treatments, ranging from active surveillance to radiation or surgery, is becoming increasingly accepted by physicians, since curing cancer can be as important as improving quality of life to patients. It is difficult for physicians to make a prognosis about the exact location of prostate cancer, and upon treatment, there is the risk of incontinence and erectile dysfunction, which is why options need to be discussed between patients and doctors.
However, the authors of the recent study comment that an informed discussion is only possible if the patient is aware of the implications of the treatments and if the physician knows the personal situation and needs of the patient. “Such truly shared decision-making is a relatively new phenomenon in medicine. Traditionally we assumed that the doctor always knows best,” clinical researcher, Kari Tikkinen, an adjunct professor of clinical epidemiology from the Department of Urology at the university, said in a news release.
The international research group led by Kari Tikkinen conducted a meta-analysis, during which they reviewed 14 randomized studies that included a total of 3,377 people to assess the impact of decision aids in treatment choices. The study demonstrated that the most typical type of decision aid given to patients was written information but also videos, lectures, discussions and, less commonly, interactive computer applications.
Despite the fact that the informational materials were provided to improve the decision process, there was no significant effect on the use of individual treatment options and only a modest impact in decreasing the feelings of regret about the chosen treatment.
“Ideally, patients would first receive an information package in the format most useful to them — such as a booklet or an interactive computer application — which they could then study privately or together with his loved ones and nurses before the clinical consultation,” explained the first author of the study, Philippe Violette from the Department of Urology, Woodstock General Hospital in Canada. “In addition, the doctor should have a concise information package available for the appointment, so the patient can revise the main points together with his doctor both visually and in writing.”
Tikkinen added that further research in other medical fields, including studies that separate decision aids for clinical consultation, could help increase the understanding of patients and, consequently, improve the decision making process. “The patient will be more committed to the decision if he is involved in it. This may also lead to better treatment results and, ultimately, to greater satisfaction among both patients and medical staff,” concluded the researcher.