What are our goals as advanced prostate cancer survivors and what are the goals of our oncologists? Often they are not the same!
This misalignment between our expectations and those of our clinicians is common, but inexcusable. These issues become clear when we look at issues surrounding our quality of life. The treatments for advanced prostate cancer either provide for the prolongation of life or for the improvement in our quality of life, not both!
In a study presented at the May 2012 AUA conference the investigators looked at how men with advanced prostate cancer that had become castrate-resistant (mCRPC) and their physicians discuss treatment goals.
In this study the investigators analyzed conversations between 42 patients (69% African-American) and their doctors (7 oncologists and 7 urologists) during their naturally occurring clinic visit in 2011.
They found that neither patients’ goals for therapy nor the terminal nature of the disease was discussed!
After the clinic visits both the patient and the doctor were interviewed. In post-visit interviews, physicians primarily viewed the care plan as preserving quality of life while patients tended to believe their care plan focused on extending life!
Both the patients and the physicians reported that their views on treatment goals were aligned with each other. The failure to have any direct discussion of the treatment goals between the doctors and their patients allowed this misalignment between the healthcare providers and their patients.
Presented at AUA 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
Joel T Nowak, M.A., M.S.W.