Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study

J Cancer Educ. 2018 Feb;33(1):180-185. doi: 10.1007/s13187-016-1073-7.


This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p < 0.001), decreased decisional conflict (p < 0.001), and more favorable perceptions of AS (p = 0.001). Furthermore, 25 of the 30 participants (83 %) initiated AS. Increased family and clinician support predicted this choice (p < 0.001). DSI/SDM prepared patients to make an informed decision. Perceived support of the decision facilitated patient choice of AS.

Keywords: Active surveillance; Decision support interventions; Prostate cancer; Shared decision making.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Choice Behavior*
  • Decision Making*
  • Humans
  • Male
  • Middle Aged
  • Patient Participation
  • Pilot Projects
  • Population Surveillance*
  • Practice Patterns, Physicians'*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / therapy*
  • Watchful Waiting / methods*