AUA 2012 - The absence of goal setting in the dialogue between metastatic prostate cancer (mCRPC) patients and their physicians: An opportunity for shared decision making? - Another Perspective

ATLANTA, GA USA (UroToday) -

Aligning Treatment Goals Involves Patient-Physician Dialog

An interesting podium presentation by Brad Davidson, et al. addressed the absence of goal setting between metastatic prostate cancer (mCRPC) patients and their physicians. Keystone to this conversation is mutually defining the phrases “quality of life” versus “quantity of life.” Studies by Fowler (JAMA 2000) and Smith (J Supportive Oncology 2011) both reported patients are not distressed by prognostic and treatment information.

The researchers sought to understand how mCRPC patients and their physicians mutually discuss treatment goals. Clinic visits were videotaped with patient-physician consent. Of the 42-mCRPC clinic visits of which 69% were African American patients, 7 urologists and 7 oncologists were involved. In all of these visits, the discussion about patient goals for therapy or the terminal nature of their disease never took place. Physicians were interviewed by the research team following the patient visit and completed a standardized questionnaire. The urologists and oncologists in this study prioritized the care plan by preserving “quality of life.” In contrast, the patients were also independently interviewed and completed a questionnaire. These patients identified “quantify of life” to be most important. Both groups assumed their treatment goals were aligned. The absence of dialog engulfed the differences.

This study emphasizes the need to enhance communication between the patient and physician aligning treatment goals and defining expectations.

This study was support by Janssen Scientific Affairs.

Presented by Brad Davidson, Matthew DiChiara, Robert A Bailey, Lorie A Ellis, Mekre’ Senbetta, Andrew J Stephenson, and Tracey L Krupski at the American Urological Association (AUA) Annual Meeting - May 19 - 23, 2012 - Georgia World Congress Center - Atlanta, GA USA

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