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Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study

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Abstract

This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p < 0.001), decreased decisional conflict (p < 0.001), and more favorable perceptions of AS (p = 0.001). Furthermore, 25 of the 30 participants (83 %) initiated AS. Increased family and clinician support predicted this choice (p < 0.001). DSI/SDM prepared patients to make an informed decision. Perceived support of the decision facilitated patient choice of AS.

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References

  1. American Cancer Society (2015) Cancer facts & figures 2015. American Cancer Society, Atlanta, GA

    Google Scholar 

  2. Welch HG, Albertsen PC (2009) Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening: 1986–2005. J Natl Cancer Inst 101:1325–3

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cooperberg MR, Broering JM, Carroll PR (2010) Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol 28:1117–4

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chou R, Croswell JM, Dana T et al (2011) Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 155:762–771

    Article  PubMed  Google Scholar 

  5. Cooperberg MR, Carroll PR (2015) Trends in management for patients with localized prostate cancer, 1990–2013. JAMA 314:80–82

    Article  CAS  PubMed  Google Scholar 

  6. Ritch CR, Grave AJ, Keegan KA et al (2015) Increasing use of observation among men at low risk for prostate cancer mortality. J Urol 193:801–806

    Article  PubMed  Google Scholar 

  7. Weiner AB, Patel SB, Etzioni R et al (2015) National trends in the management of low and intermediate risk prostate cancer in the United States. J Urol 193:95–102

    Article  PubMed  Google Scholar 

  8. Womble PR, Montie JE, Ye Z (2015) Contemporary use of initial active surveillance among men in Michigan with low-risk prostate cancer. Eur Urol 67:44–50

    Article  PubMed  Google Scholar 

  9. Volk RJ, McFall SL, Cantor SB et al (2014) ‘It’s not like you just had a heart attack’: decision making about active surveillance by men with localized prostate cancer. Psychooncology 23:467–472

    Article  PubMed  Google Scholar 

  10. Xu J, Neale AV, Dailey RK et al (2012) Patient perspective on watchful waiting/active surveillance for localized prostate cancer. J Am Board Fam Med 25:763–770

    Article  PubMed  PubMed Central  Google Scholar 

  11. Anandadas CN, Clarke NW, Davidson SE et al (2011) Early prostate cancer—which treatment do men prefer and why? BJU Int 107:1762–1768

    Article  PubMed  Google Scholar 

  12. Lin GA, Aaronson DS, Knight SJ et al (2009) Patient decision aids for prostate cancer treatment: a systematic review of the literature. CA Cancer J Clin 59:379–390

    Article  PubMed  Google Scholar 

  13. Violette PD, Agoritsas T, Alexander P et al (2015) Decision aids for localized prostate cancer treatment choice: systematic review and meta-analysis. CA J Clin 65:239–251

    Article  Google Scholar 

  14. Stacey D, Légaré F, Col NF et al (2014) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 1, CD001431

    Google Scholar 

  15. Gomella LG, Lin J, Hoffman-Censits J et al (2010) Enhancing prostate cancer care through the multidisciplinary approach: a 15-year experience. J Oncol Pract 6:e5–e10

    Article  PubMed  PubMed Central  Google Scholar 

  16. Vernon SW, Myers RE, Tilley BC (1997) Development and validation of an instrument to measure factors related to colorectal cancer screening adherence. Cancer Epidemiol Biomarkers Prev 6:825–832

    CAS  PubMed  Google Scholar 

  17. Tiro JA, Vernon SW, Hyslop T et al (2005) Factorial validity and invariance of a survey measuring psychosocial correlates of colorectal cancer screening among African Americans and Caucasians. Cancer Epidemiol Biomarkers Prev 14:2855–2861

    Article  PubMed  Google Scholar 

  18. O’Connor AM (1995) Validation of a decision conflict scale. Med Decis Making 15:25–30

    Article  PubMed  Google Scholar 

  19. Wilt TJ (2014) Management of low risk and low PSA prostate cancer: long term results from the Prostate Cancer Intervention versus Observation Trial. Recent Results Cancer Res 202:149–169

    Article  PubMed  Google Scholar 

  20. Heidenreich BPJ, Bellmunt J et al (2013) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update, 2013. Euro Urol 65:124–137

    Article  Google Scholar 

  21. Hayes JH, Ollendorf DA, Pearson SD et al (2010) Active surveillance compared with initial treatment for men with low-risk prostate cancer: a decision analysis. JAMA 304:2373–2380

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Christie DR, Sharpley CF, Bitsika V (2015) Why do patients regret their prostate cancer treatment? A systematic review of regret after treatment for localized prostate cancer. Psych-Oncol 24:1002–1011

    Article  Google Scholar 

  23. Jang TL, Bekelman JE, Liu Y et al (2010) Physician visits prior to treatment for clinically localized prostate cancer. Arch Intern Med 170:440–450

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shappley WV, Kenfield SA, Kasperzyk JL et al (2009) Prospective study of determinants and outcomes of deferred treatment or watchful waiting among men with prostate cancer in a nationwide cohort. J Clin Oncol 27:4980–4985

    Article  PubMed  PubMed Central  Google Scholar 

  25. National Comprehensive Cancer Network guidelines for prostate cancer (2015) Corrections to Version 1.2015 of the NCCN Guidelines for Prostate Cancer.

  26. Chen RC, Rumble B, Loblaw DA et al. (2016) Active surveillance for the management of localized prostate cancer (Cancer Care Ontario Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement. J Clin Oncol doi: 10.1200/JCO.2015.65.7759.

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Acknowledgment

This project was funded, in part, under a grant with the Pennsylvania Department of Health (SAP No. 41000062221). The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions.

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Authors and Affiliations

  1. Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA

    Ronald E. Myers, Amy E. Leader, Jean Hoffman Censits, Anett M. Petrich, Anna M. Quinn, Charnita M. Zeigler-Johnson & Veda N. Giri

  2. Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA

    Edouard J. Trabulsi, Costas D. Lallas & Leonard G. Gomella

  3. Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA

    Scott W. Keith & Sarah E. Hegarty

  4. Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA

    Robert B. Den, Mark D. Hurwitz & Adam P. Dicker

  5. School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, USA

    Hasan Ayaz

Authors
  1. Ronald E. Myers
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  2. Amy E. Leader
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  3. Jean Hoffman Censits
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  4. Edouard J. Trabulsi
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  5. Scott W. Keith
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  6. Anett M. Petrich
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  7. Anna M. Quinn
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  8. Robert B. Den
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  9. Mark D. Hurwitz
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  10. Costas D. Lallas
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  11. Sarah E. Hegarty
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  12. Adam P. Dicker
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  13. Charnita M. Zeigler-Johnson
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  14. Veda N. Giri
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  15. Hasan Ayaz
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  16. Leonard G. Gomella
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Corresponding author

Correspondence to Amy E. Leader.

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This study was approved by the Thomas Jefferson University Institutional Review Board.

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Myers, R.E., Leader, A.E., Censits, J.H. et al. Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study. J Canc Educ 33, 180–185 (2018). https://doi.org/10.1007/s13187-016-1073-7

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  • DOI: https://doi.org/10.1007/s13187-016-1073-7

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