Patient-Centered Treatment Decision Making in Advanced Prostate Cancer
Abstract
Scientific Objective and Rationale: During the last decade, scientists have made tremendous advances in treatments for advanced prostate cancer. Because of this, advanced prostate cancer survivors are commonly living for years and facing multiple treatment decisions during that time. Therapies for metastatic castration-resistant prostate cancer, the most advanced form of the disease, have different side effects, co-pay requirements, and follow-up visit schedules. However, each therapy lengthens life by approximately the same amount (3-4 months on average). Physicians do not have scientific tools or tests to match the "right" treatment with a particular man, and treatments are often chosen based on the physician s personal experience or by what he or she believes an individual patient would prefer. An alternative approach to treatment decisions for men with advanced prostate cancer is to actively engage men in conversations about what matters to them and to discuss treatment options in the context of an individual s personal values and preferences. Shared decision-making is a method by which men and their physicians purposefully engage in treatment discussions to identify a therapy that best matches both an individual patient s preferences and the physician s thoughts about his clinical condition. The Institute of Medicine has called upon physicians to incorporate shared decision-making into clinical practice, noting that doing so improves the quality of care, patient satisfaction, decision satisfaction, and health and quality of life outcomes. Shared decision-making has been studied among women with breast cancer and other cancer patients, but has not been studied among men with advanced prostate cancer. Understanding treatment decisions and the potential role for shared decision-making in prostate cancer treatment decisions will allow me to develop patient engagement and decision-support methods that will improve the physical and emotional well-being of prostate cancer survivors. Principal Investigator s Career Goals in Prostate Cancer Research and Cancer Care: My long-term career goal is to improve the health outcomes and quality of life of men with advanced prostate cancer by enhancing treatment decision-making. I am equally passionate about providing clinical care to men with prostate cancer. This allows me to positively impact patients on an individual level, and to focus my research on the issues that are most important to my patients. The proposed research and education plans intertwine, enabling me to answer key research questions about the potential effects of shared decision-making on prostate cancer survivors and simultaneously build expertise in decision-making, statistical techniques important for analyzing the data we collect, and decision-aid development to support decision-making in future studies and clinical practice. The experience, knowledge, and skills I will gain from completing the proposed training and research plans are precisely what I need to become an independent investigator with specific expertise in treatment decision-making and advanced prostate cancer survivorship. Applicability of the Proposed Research: The proposed project seeks to improve the quality of life of advanced prostate cancer survivors by enhancing decision-making in this group within the next 4-5 years, and by establishing a next-generation leader in the field of prostate cancer research. The work will enhance our understanding of the way men with advanced prostate cancer make treatment decisions, and the knowledge gained will be used to develop decision-support aids to optimize methods of decision-making that are associated with better prostate cancer outcomes, including the decision satisfaction and quality of life. Contributions to Advancing the Field of Prostate Cancer Research: This project will contribute to the field of prostate cancer care and research by advancing our understanding of the deci
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610554
Entities
People
- Alicia K Morgans
Organizations
- United States Army
- Vanderbilt University