Clinical Urology

Objective: There are a number of avenues to treat localized invasive prostate cancer, including surgery, radiotherapy and active surveillance. However, each option carries its unique side effect profile, and the decision on one over another usually encompasses tradeoffs between the patient, the surgeon and the physician. This paper investigates the role of decision aids in helping patients choosing the right treatment. Methods: A multi-field search was conducted using the key words ‘Uro’ and ‘Robo’ and ‘Prostatecto’ and ‘Decisio’. Inclusion criteria were articles that investigated the impact of decisional aids with decisional outcomes. Studies not related to locally-invasive prostate cancer were excluded accordingly. Results: The issues pertinent to men in deciding treatment were tumor eradication rate, side effects and impacts on quality of life. For men to decide an option, the more decisional control they had, the less decisional conflict they experienced and the more satisfied they would be. The literature is scant on studies that investigated specifically on robotic-assisted radical prostatectomy. Six RCTs were available for comparing the selection of radical prostatectomy vs. radiation therapy. However, data was non-specific with regards to the proportion of robotic-assisted prostatectomy included in the studies, except for one study. Conclusions: We concluded that the patient-physician interview should be best equipped with an encounter decision aid to facilitate the discussion of different treatments. The information shared to patient may include the benefits, harms and burden of alternatives. The ultimate role of a decisional aid is to support patients in considering what matters most to them.