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Patient Participation in Consultations for Clinically Localized Prostate Cancer.

Paul Kokorowski1, Nadine A Friedrich2,3, Michael Luu4

  • 1Departments of Urology and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California.

The Journal of Urology
|October 10, 2025
PubMed
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This summary is machine-generated.

Patient participation in prostate cancer treatment decisions varies widely. Little time is spent on patient preferences, highlighting a need for providers to actively elicit values and decision-making input.

Area of Science:

  • Urology
  • Health Services Research
  • Patient-Provider Communication

Background:

  • Shared decision-making (SDM) is crucial for prostate cancer (PCa) treatment.
  • Physician roles in SDM are well-studied, but patient roles require further characterization.
  • Understanding patient participation is key to improving SDM in localized PCa consultations.

Purpose of the Study:

  • To describe variations in patient participation during localized prostate cancer consultations.
  • To analyze the thematic content of patient speech during these consultations.
  • To identify factors influencing patient engagement in SDM for PCa treatment.

Main Methods:

  • Analysis of 6,601 patient statements from 50 multispecialty consultations across 10 providers.
Keywords:
multidisciplinary treatment consultationsprostate cancer

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  • Open coding approach to categorize patient speech content and types.
  • Generalized linear mixed models used to identify predictors of patient speech and SDM-related statements.

    • Main Results:

    • Patient speech constituted a median of 19.9% of consultation words, with significant variability (1.8%-51.1%).
    • Patient statements primarily included acknowledgments (27.7%), providing information (34.5%), and questions/requests (21.5%).
    • Only tumor risk predicted engagement in SDM; no other sociodemographic or preference factors were significant predictors.

    Conclusions:

    • Patient participation in PCa consultations is highly variable and lacks consistent predictors.
    • Limited time is dedicated to patients expressing preferences, values, or engaging in the decision-making process.
    • Providers should adapt practices to ensure adequate patient participation, focusing on eliciting values and preferences.