Patients and physicians need to be active coparticipants in discussions about prostate cancer treatment: “patients, by asking questions and making sure that doctors know their preferences—for example, how important sexual function or control of urination is to them—and clinicians, by inviting patients into the decision,” noted Michael J. Barry, MD, Medical Director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital, Boston.

“Maybe the entrée into that conversation is, ‘Let’s talk about some of the things that are important to you in this decision,’” he continued. “Clinicians can raise the issue that these treatments can in some circumstances reduce the risk of dying of prostate cancer, but there are side effects, and two of the big ones are problems with sexual function and problems with control of urination. Certainly offering data from the paper by Sanda and colleagues to the many men for whom sexual function will be an issue is a great idea.”

Dr. Barry advised that the information on sexual functioning gleaned from this study should be presented along with information from randomized trials about other outcomes. “As we get more data on all these outcomes, we can synthesize that for men and really give them a good evidence-based overview of the pros and cons of the different treatment choices,” he said.

Dr. Barry, who is also President of the Foundation for Informed Medical Decision Making Information, suggested that patients and physicians visit the foundation’s website at www.informedmedicaldecisions.org. ■

Disclosure: Dr. Barry receives salary support as president and a board member of the Foundation for Informed Medical Decision Making. The Foundation receives project funding and royalties from Health Dialog. His institution receives grant support from the NIH.