Better Conversations, Better Choices: Shared Decision-Making in Prostate Cancer Care Timothy J. Daskivich, MD, MSHPM; Maria P. Mogollon, MD

https://www.medscape.com/viewarticle/better-conversations-better-choices-shared-decision-making-2026a100121a?src= Shared decision-making (SDM) — the process by which doctors and patients collaboratively arrive at a treatment decision informed by both clinical evidence and the values and preferences of the patient — is a fundamental component of daily urologic practice. Because localized prostate cancer (PC) treatment options offer comparable oncologic outcomes, patients make choices on therapy based on side effects, salvage options, invasiveness, duration of therapy, and their own personal preferences. For this reason, comprehensive and balanced discussion of all these considerations is required for SDM to be successful. Yet, while SDM is universally endorsed by guidelines, execution in clinical practice is often suboptimal, and objective studies have found that physicians spend little time on patient engagement. In this article, we offer insights on how to optimize patient-physician communication for SDM, citing data on how doctors communicate in real-world practice to inform a structure for the conversation and how to avoid common pitfalls.