PCORI implementation projects promote the use of findings from PCORI-funded studies. The initiative on Implementation of Effective Shared Decision Making Approaches in Practice Settings funds projects like this one to promote the use of shared decision making strategies tested in PCORI-funded studies or incorporating evidence from PCORI-funded research, to support patients in making informed decisions about their care.
This project focuses on implementing findings from the completed PCORI-funded research project: Comparing the Effects of Surgery, Radiation Therapy, and Active Surveillance on Men with Localized Prostate Cancer – The CEASAR Study
This project is in progress.
What were the results from the original PCORI-funded research study?
The original study compared three common treatments for prostate cancer that hasn’t spread beyond the prostate gland. After three years, men who had surgery reported lower sexual function and more leaking of urine than men who had radiation or regular check-ups to see if the cancer had spread. However, men who had surgery reported fewer other urine problems, such as painful urination or passing urine often.
Why is this research finding important?
Prostate cancer is one of the most common types of cancer in men. It is especially common in African-American men. Treatment may help men live longer, but surgery and radiation treatment have side effects, like problems having sex or urinary or bowel problems. Prostate cancer often grows slowly, so men who have a low risk of their cancer spreading can also choose a watch-and-wait approach with regular check-ups instead of having treatment right away. Results from this study may help men choose a treatment that’s right for them or decide if they want to watch and wait.
What is the goal of this project?
The project team wants to bring results from this and other research studies to men with prostate cancer that hasn’t spread, so they can work with their doctors to choose a treatment. The team is adding results from the research study to a decision aid that helps doctors and patients work together to make choices based on what is most important to the patient.
What is the project team doing?
The project team is updating a decision aid already in use at the University of California, Los Angeles, with information from the recent prostate cancer study. Patients review this decision aid before they meet with their doctors. The decision aid includes information about prostate cancer and treatment options. It also asks patients about what is most important to them when it comes to treating their prostate cancer. After the patient reviews the decision aid, the doctor receives a summary of the patient’s preferences.
The team is working with two other health systems in Tennessee and California to put the decision aid into use and assess how it works in those locations.
How is the team evaluating this project?
The project team is looking at how often doctors and patients use the decision aid when making decisions about prostate cancer treatment. They are also tracking whether the shared decision making process, including using the decision aid, works consistently at each health system and for all patients. The team is following up with patients to see what treatment they choose and if they are satisfied with their choice.
How is the team involving patients and others in making sure the findings reach people who can use them?
Men with prostate cancer and their spouses are working with the project team to make sure the decision aid includes information that matters to patients, such as how results of treatment might differ depending on race. The team is working with prostate cancer groups to share the results of the project.
Learn more about PCORI’s Dissemination and Implementation program here.
Related PCORI-funded Research Project
Note: Results from the original project have completed PCORI's Peer Review and are available here.
Study Lets Prostate Cancer Patients Give Input to Help Others Choose Best Treatment
The Tennessean, April 20, 2019
In a guest opinion column, Ralph Conwill—a prostate cancer survivor and a patient partner on the related original research study—writes about his involvement in the research and notes that he served as "an equal partner ... alongside the scientists in what is a truly patient-centered approach." Conwill adds that he is now assisting researchers in this project.