The best patient-physician relationship involves joint decision-making by both parties based upon current, accurate, and appropriate information. Thus, in order to make the best decisions, both parties need to be well informed.
The California Prostate Cancer Coalition (CPCC) is just one of many state prostate cancer organizations participating in the National Alliance of State Prostate Cancer Coalitions (NASPCC) that has made informed decision-making part of its mission statement. In reality, this means educating both the prospective patient and the physician.
Both NASPCC and CPCC (among other state prostate cancer organizations) utilize a durable awareness and educational tool, referred to as the “Laminate,” that helps men 40 and older ask their doctor questions that will enable them to make informed decisions about whether to get tested for prostate cancer.
Asking the right questions
There are 10 questions and answers, using words designed for the layman (not for the physician). The beauty of the Laminate is that the flip side of the durable 8 ½ x 11 tool is “Informed Decision-Making for Primary Care Providers,” those at the forefront of seeing most patients and deciding whether to test PSA, perform a digital rectal examination, and otherwise look for prostate cancer.
The same 10 questions appear on this flip side for physicians but the answers are more medical and scientific. The patient is able to read both sides and the physician can do so as well, letting them know in advance what questions the patients will be asking them personally. The Laminate can be found here: http://prostatecalif.org/patient-guide.
The Laminate is about deciding whether to get tested for prostate cancer. Farther along the continuum, in order to keep patients and physicians informed to enable better shared decision-making, NASPCC is working on an Advanced Prostate Cancer Laminate, which also asks 10 questions (lay answers on one side, scientific answers to the same 10 questions on the flip side, as with the other).
These questions have to do with types of advanced prostate cancer, such as hormone-resistant and hormone-sensitive, metastatic or not. Some palliative (non-curative-intent) care may be part of the scenario, but there is also a new emphasis lately on prostate cancer that requires a different kind of treatment: treatment meant to delay or prevent metastases.
New developments as above, combined with the latest scientific research and results of clinical trials, plus genomic as well as genetic testing, help inform us about prostate cancer in ways we never imagined. We need to make that information available and share it widely with patients and physicians, so the basis of their shared decision-making is informed and appropriate.
Merel Grey Nissenberg, Esq., President, National Alliance of State Prostate Cancer Coalitions, [email protected]