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. 2010 Feb;56(2):137-41.

Helping patients with localized prostate cancer reach treatment decisions

Kathryn Birnie  1 , John Robinson
Affiliations

Helping patients with localized prostate cancer reach treatment decisions

Kathryn Birnie et al. Can Fam Physician. 2010 Feb.

Abstract
in English, French

Objective: To highlight the role of psychosocial variables in treatment decision making for patients with localized prostate cancer and how family physicians can be of most help to such patients in facilitating good treatment choices.

Quality of evidence: PubMed was searched, and articles relevant to the psychosocial aspects of localized prostate cancer treatment decision making were included. Articles were excluded when they clearly specified inclusion of men with metastatic disease. This is not a systematic review, and recommendations made are drawn from studies of level II or III evidence.

Main message: The optimal strategy for managing localized prostate cancer has not been established and currently includes a number of potential options: active surveillance, radical prostatectomy, external beam radiotherapy, brachytherapy, and cryoablation. Consequently, men often struggle during the decision-making process, and some later regret their decisions. With an increased awareness of the psychosocial aspects of patient decision making, family physicians can help patients make better decisions.

Conclusion: Family physicians can help minimize the decisional regret experienced by patients after treatment by encouraging patients to consider their values and social supports, as well as the accuracy and appropriateness of the information used in the decision-making process.

OBJECTIF: Décrire les variables psychosociales qui influencent la décision du choix de traitement pour un cancer prostatique in situ et montrer comment le médecin de famille peut aider le patient à choisir un traitement approprié.

QUALITÉ DES PREUVES: On a consulté PubMed et retenu les articles traitant des aspects psychosociaux de la prise de décision concernant le traitement d’un cancer prostatique in situ. Les articles qui indiquaient clairement comprendre des patients avec une maladie métastatique ont été exclus. Il ne s’agit pas d’une revue systématique, et les recommandations émises proviennent d’études dont les preuves sont de niveau II ou III.

PRINCIPAL MESSAGE: La stratégie thérapeutique optimale pour un cancer prostatique in situ n’a pas encore été établie, les options actuelles incluant: surveillance active, prostatectomie radicale, téléthérapie, brachythérapie et cryoablation. Les patients ont donc souvent de la difficulté à faire un choix et plus tard, certains regrettent leur décision. Avec une meilleure connaissance des facteurs psychosociaux qui influencent la décision du patient, le médecin de famille peut l’aider à faire un choix plus éclairé.

CONCLUSION: Le médecin de famille peut minimiser les regrets qu’éprouvent les patients après avoir reçu le traitement de leur choix en les encourageant à tenir compte de leurs valeurs personnelles et de leurs supports sociaux, mais aussi de la justesse et de la pertinence des informations utilisées dans le processus décisionnel.

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Comment in

  • If only we could predict the future!
    Ladouceur R. Ladouceur R. Can Fam Physician. 2010 Feb;56(2):117-8. Can Fam Physician. 2010. PMID: 20154235 Free PMC article. No abstract available.
  • What would you do, Doc?
    Katz A. Katz A. Can Fam Physician. 2010 May;56(5):412. Can Fam Physician. 2010. PMID: 20463265 Free PMC article. No abstract available.
  • First do no harm?
    Harvey BJ, Miller AB. Harvey BJ, et al. Can Fam Physician. 2010 May;56(5):412. Can Fam Physician. 2010. PMID: 20463266 Free PMC article. No abstract available.

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