We have to bring emotions into this thought process, not only to help the process along, but also to ensure the men are satisfied with their decision, given all the information currently on hand. Emotions here fall into a few categories.
- The what ifs Of all the possible side effects (urinary, bowel, erectile function mainly), “Which ones could I live with? Which ones would ruin my life?”
- Gut level feelings “I just got along better with that doctor vs. the other …” “My brother did great with that treatment, so I think I’ll go that route.”
- How decisions affect my loved ones “I’m debating between active surveillance and surgery, but I think my wife would be too worried day to day if I decided just to watch and wait versus take it out.”
Even more than poker, cancer is still a mystery. Dealing with cancer is both a science and an art, from both the patient’s and health care provider’s perspectives. Decisions are rarely 100% based on statistics and rationality alone. Decisions purely based upon emotion can be impulsive and sometimes foolish.
As oncology nurse navigators, we can take on the role of a shared-decision making coach, advocating for patients as a nonvested third party with their best interests in mind.
All I know is that the men who carefully—but not compulsively—considered all aspects of their prostate cancer treatment seem to be the most satisfied and comfortable with their decision, even years out, no matter what the outcome.
• Informed Medical Decisions Foundation. Healthwise Research and Advocacy. http://www.informedmedicaldecisions.org/. Accessed March 12, 2015.
• Patient decision aids. Ottowa Hospital Research Institute web site. http://decisionaid.ohri.ca/decguide.html. Accessed March 12, 2015.