Principal Results
anxiety, cancer, Chase Cancer, Depression, prostate cancer
ONCOLOGY, CANCER, FOX, PROSTATE CANCER
In this study, we demonstrated that both the Healing Choices and Healium programs are successful in reducing decisional conflict. A nearly 30-point drop in decisional conflict, as achieved by both programs, is clinically relevant. Indeed, it indicates a reduction from clinically significant conflict to almost no conflict at all. The lack of decisional conflict was accompanied by an increase in decisional satisfaction from 6 weeks to 3 months postbaseline assessment and there was no difference in emotional quality of life between participants receiving the 2 programs. Remarkably, patients reported low levels of anxiety or tension at baseline, which then further declined, albeit nonsignificantly. These low levels of anxiety or tension diverge from levels published in the literature, which usually show moderate to high levels of distress after a receipt of a prostate cancer diagnosis. Depression at baseline was somewhat higher, but still at a subclinical level, and declined significantly at 6 weeks. The reason for these low levels of affect prior to the physician consultation is unclear; yet, it is possible that patients’ anxiety was lower because they were focusing on the fact that they were going to resolve their cancer threat.Healium was successfully implemented within 2 separate clinic sites (Northwell Health and Fox Chase Cancer Center). Indeed, within each site, patients were recruited from Urology and Radiation Oncology, demonstrating the utility of using Healium before a consultation with either a surgical oncologist or radiation oncologist.It is noteworthy that when comparing the 2 programs, patients randomized to Healium were more likely to select active surveillance than active treatment (either surgery or radiation), while those randomized to Healing Choices were more likely to select active treatment (either surgery or radiation) than active surveillance. Evidence in the literature indicates that patients who use shared decision-making, the core of Healium, tend toward choosing less aggressive treatment options, such as active surveillance. It has been suggested that the deeper processing of the pros and cons of treatment options leads to less aggressive treatment approaches.