Andreas Ihrig

Decision-making in localized prostate cancer: lessons learned from an online support group.

Study Type – Patient (preference/ecological) 
Level of Evidence 2c

Treatment decision-making in localized prostate cancer: why patients chose either radical prostatectomy or external beam radiation therapy

Study Type – Therapy (case series)

The effect of an online support group on patients׳ treatment decisions for localized prostate cancer: An online survey

OBJECTIVE To analyze the effect of an online support group (OSG) on the final treatment decision for localized prostate cancer. METHODS We performed a cross-sectional descriptive study of the largest German prostate cancer OSG between July and October 2013. The online survey comprised 127 questions covering sociodemographic and disease-related information, decision-making habits, health-related quality of life, distress, depression, and anxiety. The primary outcome was to measure the effect of an OSG on the final treatment decision. RESULTS We analyzed the completed questionnaires from 686 patients with prostate cancer, 200 (29.2%) of whom revised their initial treatment decision. After revising their decisions, these patients more frequently underwent external beam radiation therapy (44.5% vs. 36.4%, P = 0.048) and active surveillance (10.5% vs. 3.7%, P<0.001) and less frequently underwent radical prostatectomy (52.5% vs. 74.9%, P<0.001). Engaging longer in the OSG, demanding a more active role in the decision-making process, and participating in a conventional support group were independently associated with revision of the initial treatment decision. CONCLUSIONS Of all patients participating in the OSG, 29.2% revised their initial treatment decision. We estimate that this phenomenon may affect 17,000 patients with prostate cancer in the United States of America every year. This finding highlights the importance of OSGs for the health care system. The patient׳s desired degree of involvement in decision-making should be routinely clarified to adjust counseling accordingly. TRIAL REGISTRATION www.germanctr.de, number DRKS00005086.

The complex interplay of physician, patient, and spouse in preoperative counseling for radical prostatectomy: a comparative mixed-method analysis of 30 videotaped consultations.

Spouses of cancer patients play a crucial role in deciding on therapeutic choices. The aim of our study was to assess their role in counseling for radical prostatectomy.

Results of a Patient Survey for Assessment Services in Renal Transplant Patients With a History of Cancer

Patients with cancer who require a kidney transplant often face a prolonged time on the waiting list to ensure a sufficient relapse-free time. Patients and relatives were invited to the patient assessment service where they get an individualized risk assessment and a recommendation for transplantation and waiting period directly from an expert panel. We investigated in 31 patients who filled out questionnaires concerning depression, anxiety, distress, and quality of life and were interviewed for their satisfaction, experiences, and circumstances of the counseling. In 12 (39%) of the 31 patients, a recommendation for transplantation could be made, although the regular waiting period was not yet achieved. The assessment service was received as very good or good by 22 (79%) of 28 patients. We found no relevant differences in patients with regular and shortened waiting time. An interdisciplinary assessment service is a valuable instrument to help with a decision-making between 2 life-threatening conditions.