Study highlights ways to improve patient-centered consultations in prostate cancer

In a recent video, Timothy Daskivich, MD, MSHPM, and Nadine Friedrich, MD, highlighted the importance of strengthening shared decision-making (SDM) practices in urology, particularly for prostate cancer care. Their research emphasizes incorporating explicit descriptions of the decision-making process into future American Urological Association (AUA) guidelines.

Daskivich noted that guidelines are central to shaping physician behavior and strongly influence clinical practice. Although the AUA has produced valuable resources, including prostate cancer–specific guidelines and a white paper on SDM, he stressed the need for ongoing updates. As understanding of SDM evolves, guidelines should reflect new insights into what elements matter most in real-world consultations and which may no longer be relevant. He emphasized that their study offers empirically derived evidence—an analysis of actual physician–patient conversations—providing a data-driven complement to existing expert opinion frameworks.

Friedrich echoed this point, adding that although SDM principles are embedded within guidelines, they are often implicit. The strength of their research lies in making these processes explicit, grounded in real-world interactions rather than solely professional consensus. Both agreed that integrating such evidence into future guideline updates could meaningfully enhance patient-centered care.

From a practical standpoint, both experts stressed the value of setting expectations early in the consultation. Friedrich recommended beginning visits by clearly outlining the decision-making process and clarifying the respective roles of physician and patient. This can be followed by open-ended questions to elicit patient preferences and values, fostering trust and comfort. Daskivich added that addressing common patient assumptions—such as the belief that decisions should rest solely with the physician—helps avoid confusion or frustration. Framing the discussion with a few sentences at the start ensures that patients understand their input is essential, ultimately leading to higher-quality, more collaborative decisions.

REFERENCE

1. Friedrich NA, Kokorowski P, Luu M, et al. Topic mapping to inform content to discuss in shared decision-making for prostate cancer. Urology. 2025 May 28:S0090-4295(25)00511-4. doi:10.1016/j.urology.2025.05.053