Shared decision-making between nmCRPC patients and the healthcare team

Hello, my name is Joanie Pfahl. I am a resident nurse with the Atlantic Urology Clinics in Myrtle Beach, South Carolina. I’m going to talk about: Strengthening shared decision making between non-metastatic castrate-resistant prostate cancer patients and the healthcare team, and how we can use the GUIDE communication framework to support discussions with our patients.

Inform and educate the patient about treatment options

We will be focusing on step 3 of the framework, which includes how and what are the best ways to inform and educate the patient with regards to their treatment options. Since 2018, the treatment landscape for non-metastatic CRPC has changed with the approval of three next-generation oral androgen receptor inhibitors. They are apalutamide: SPARTAN trial, enzalutamide: PROSPER trial, and darolutamide with ARAMIS trial.

With the availability of the new AR target option, oncology nurses play a crucial role in the decision-making process; with educating, supporting, and to help the patients manage their prostate cancer. While ensuring they receive the most appropriate information to help their treatment decisions. It is essential that we educate and inform patients regarding their treatment aims for non-metastatic CRPC, and they are: prolong survival, delay metastasis, alleviation of tumour-related symptoms, balancing potential benefits against likely treatment toxicity, and maintaining quality of life.

While no head-to-head comparison of apalutamide, enzalutamide and darolutamide have been conducted to date, all three have demonstrated comparable efficacy and maintained quality of life in the SPARTAN, PROSPER and ARAMIS trials, but they have differing AE profiles. So why is the GUIDE communication framework needed?

Shared decision-making

Nurses are seen as the go-to person for their patients with non-metastatic CRPC, and therefore must empower patients with guidance and support, throughout their treatment journey, ensure patients are provided with the right information with their treatment decisions and to help fill in the gaps with their patient’s knowledge, and to be an active member of the healthcare team, in delivering shared decision-making, so they can provide patients with the greatest chance of success and meaningful, prolonged length of survival; to see their new grandchild, to attend a wedding, to attend a graduation or to plan a vacation.

Please go to gunursesconnect.cor2ed.com to take an in-depth look at the prepared slides and thank you for listening to the GU NURSES CONNECT.