Prostate Shared Decision Making Overview

Besides skin cancer, prostate cancer is the most commonly diagnosed cancer in men in the United States. In 2020, the American Cancer Society estimated that more than 191,000 new cases of prostate cancer would be diagnosed in the U.S. While the five-year survival rate for localized prostate cancer is nearly 100 percent, early detection is key. According to SEER data, only about 30 percent of patients with metastatic disease at diagnosis will survive five years post-diagnosis. Castration-resistant prostate cancer, or CRPC, is also associated with poor survival rates.

Significant disparities exist regarding the onset and progression of prostate cancer. Aggressive forms of the disease are more common in Black men, and Black men are more than twice as likely to die from prostate cancer than are non-Hispanic White men. There are many factors that contribute to these disparities, including social determinants of health (e.g., low economic status, low health literacy, and lack of transportation) and being under- or uninsured. Language barriers and trust issues with the medical community may also present obstacles to optimal cancer care.

The lack of resources available to some cancer care teams may be a further contributing factor to disparities in prostate cancer care. Given the preponderance of patients with advanced prostate cancer treated at many community cancer centers, providers need effective strategies for managing patients at each stage of their treatment. One such strategy—shared decision-making—can be particularly beneficial to patients with prostate cancer. Shared decision-making proactively engages patients to be active participants in their care and enables them to work with their doctors to choose treatments tailored to their specific needs and circumstances.

Through this project, ACCC aims to discuss how the prostate cancer landscape is evolving, improve the comprehensive care management of patients with advanced prostate cancer by identifying barriers to shared decision-making, and proposing new ways to better educate patients about their treatment options. In particular, this project will target patients most likely to be affected by disparities in care by identifying individuals most at risk of suboptimal treatment outcomes based on their social determinants of health.

For more information on this project, please contact the ACCC Provider Education department.

• Comprehensive Care of Patients with Advanced Prostate Cancer through Shared Decision-Making: Landscape Analysis. By reviewing the current state of personal engagement in decision-making for patients with advanced prostate cancer, this paper identifies obstacles to shared decision-making proposes new ways to better educate patients about their treatment options.
• Virtual Multidisciplinary Summit on Treating Advanced Prostate Cancer in the Community: Executive Summary. Read outcomes from a virtual summit which explored strategies to improve care delivery and to support patient engagement in treatment decision-making in patients with advanced prostate cancer.