Sigrid V. Carlsson, MD, PhD, MPH, presented “Shared Decision Making for Prostate Cancer Decisions: When the Patient has a Laundry List and the Doctor has 8 Minutes” during the 27th Annual Perspectives in Urology: Point Counterpoint on November 9, 2018 in Scottsdale, Arizona.

How to cite: Carlsson, Sigrid V. “Shared Decision Making for Prostate Cancer Decisions: When the Patient has a Laundry List and the Doctor has 8 Minutes” November 9, 2018. Accessed Jul 2024. https://grandroundsinurology.com/shared-decision-making-for-prostate-cancer/

Shared Decision Making for Prostate Cancer Decisions: When the Patient has a Laundry List and the Doctor has 8 Minutes – Summary:

Sigrid V. Carlsson, MD, PhD, MPH discusses the psychology, history, and practical application of shared decision making. She then provides recommendations for clinicians counseling patients deciding whether or not to undergo PSA screening and if they should go on active surveillance.

Abstract:

Counseling patients about the nuanced risks and benefits of management options during a time-constrained office visit can be challenging. However, this is an essential step in shared decision making and aligning medical decisions with patient-expressed preferences and values.

Doctors understand the anatomy of the human body. But in order to responsibly practice shared decision making they must understand the human psyche. For example, urologists understand the controversies surrounding the United States Preventive Services Task Force’s unfavorable recommendations on PSA screening. However, the burden of overdiagnosis and the potential impact of a PSA test to a patient requires a different skill set.

This presentation reviews the history and psychology of shared decision making and active surveillance. Specifically, it will discuss counseling patients to make informed decisions on PSA screening with a simple schema. It will also describe a systematic approach to discussing active surveillance with patients with low-risk prostate cancer.

About Perspectives in Urology: Point Counterpoint

Perspectives in Urology: Point Counterpoint (PCP) is an annual CME-accredited conference devoted to discussing and debating the latest topics in men’s health, general urology, and genitourinary cancers. The conference’s format includes more than didactic lectures. It also includes debates, point-counterpoint discussion panels, and unique case-based presentations. Dr. Carlsson presented this lecture during the 27th PCP in 2018. Please visit this page in order to register for future IUP meetings.

ABOUT THE AUTHOR

Sigrid V. Carlsson, MD, PhD, MPH, is Director of Clinical Research at Memorial Sloan Kettering Cancer Center’s (MSKCC) Josie Robertson Surgery Center and Assistant Attending Epidemiologist, with dual appointments in MSKCC’s Departments of Surgery (Urology Service) and Epidemiology and Biostatistics. Her line of research focuses on screening and early detection of prostate cancer, including multiplex testing and risk-stratified strategies that incorporate clinical information, biomarkers and magnetic resonance imaging, as recently funded by an NIH/NCI U01 award (PI: Carlsson).

Dr. Carlsson also serves as Associate Professor of Experimental Urology affiliated with the Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, in Sweden, where she is an investigator of two large randomized controlled trials of prostate cancer screening (GOTEBORG-1&2), as recently published in the New England Journal of Medicine (Hugosson J, et al. N Engl J Med 2022). In addition, Dr. Carlsson is Adjunct Senior Lecturer in the Department of Translational Medicine in the Division of Urological Cancers in the Medical Faculty at Lund University, Lund, Sweden.

Dr. Carlsson recently completed a K22 career development award from the NIH/NCI to improve shared decision-making for breast and prostate cancer screening. She serves on the National Comprehensive Cancer Network (NCCN) and is a panel member for the American Urological Association (AUA) guidelines for early detection of prostate cancer. Before pursuing postdoctoral studies in urologic oncology at MSKCC, Dr. Carlsson was a physician in Sweden. She earned her MD and PhD from Gothenburg University in Sweden and earned an MPH from Harvard TH Chan School of Public Health in Boston, Massachusetts.