Helping patients with localized prostate cancer reach treatment decisions.

OBJECTIVE To highlight the role of psychosocial variables in treatment decision making for patients with localized prostate cancer and how family physicians can be of most help to such patients in facilitating good treatment choices. QUALITY OF EVIDENCE PubMed was searched, and articles relevant to the psychosocial aspects of localized prostate cancer treatment decision making were included. Articles were excluded when they clearly specified inclusion of men with metastatic disease. This is not a systematic review, and recommendations made are drawn from studies of level II or III evidence. MAIN MESSAGE The optimal strategy for managing localized prostate cancer has not been established and currently includes a number of potential options: active surveillance, radical prostatectomy, external beam radiotherapy, brachytherapy, and cryoablation. Consequently, men often struggle during the decision-making process, and some later regret their decisions. With an increased awareness of the psychosocial aspects of patient decision making, family physicians can help patients make better decisions. CONCLUSION Family physicians can help minimize the decisional regret experienced by patients after treatment by encouraging patients to consider their values and social supports, as well as the accuracy and appropriateness of the information used in the decision-making process.