Counselling the Prostate Cancer Patient

ContextPatient involvement in the medical decision-making process has gained a good deal of importance during the last decades. It has become widely accepted that patient values and preferences should also be considered during treatment selection when reasonable alternatives are available.ObjectiveThis paper discusses the process of shared medical decision making and the importance of informing the patient and improving patient–physician communication concerning prostate cancer (PCa).Evidence acquisitionDuring a satellite symposium at the European Association of Urology (EAU) 2008 annual meeting, the issue of shared medical decision making in PCa was presented. This paper discusses the most important messages of this presentation, supported by recent findings in the literature.Evidence synthesisIn clinical situations where data do not clearly differentiate the treatment alternatives, patient involvement in the medical decision-making process becomes critical. Therefore, patient–physician communication should be emphasised, and physicians should take the time necessary to inform the patient about potential treatment options and their expected consequences. Increasing a patient’s ability to engage physicians in a dialogue and providing patients with balanced information will contribute to a well-considered decision, which in turn can minimise future regret. Misleading information on the Internet and poor literacy skills can hamper the decision-making process. Patients are often dissatisfied with inadequate time spent during physician visits and the not-uncommon perception that treatment choices the physician presents are more restricted than optimal.ConclusionsIn current clinical practice, the patient–physician dialogue should be enhanced, and patients’ preferences should be taken into consideration in the decision-making process. This will contribute to well-considered treatment decisions and improve patient satisfaction.