Shared Decision-Making in Cancer Care: A Guide for Healthcare Providers

Key Takeaways

• 5,500 families receive a cancer diagnosis each day, and all of them will face complex decision-making difficulties surrounding treatment options and care priorities.
• Shared decision-making in cancer care helps healthcare workers and their patients balance medical realities with personal preferences, cultural values, and emotional burdens.
• By exploring shared decision-making through continuing education, healthcare workers can work closely with their cancer patients to craft care plans that are both effective and aligned with patient priorities.

It’s estimated that more than 2 million people will be diagnosed with cancer in the U.S. in 2025. That means nearly 5,500 new families will face difficult healthcare decisions every day, and how these choices are framed can drastically impact the treatment process and quality of life.

As a result, the role of health professionals is much more complicated than dictating percentages and advocating for options. Shared decision-making in cancer care seeks to strike a balance between medical realities and personal values, cultural contexts, and emotional burdens. Courses like Screening Survival: Navigating the World of Cancer Care give healthcare professionals a solid foundation for helping families chart the best path forward when facing a cancer diagnosis.

How can you help the patients and families in your care find the best possible answers when they’ve received extremely difficult news? Here’s an overview of shared decision-making in cancer care.

Why Shared Decision-Making in Cancer Care Matters

Cancer treatment plans are complex, involving a mountain of information that must be processed by the patient along with a thorough assessment of risk vs. survival benefits, side effects, and quality of life.

Evaluating risk/benefit may involve difficult conversations surrounding:

• Choosing between aggressive chemotherapy and palliative care
• Deciding whether to pursue clinical trial enrollment
• Benefits of surgery vs. long recovery periods

Shared decision-making (SDM) is the process of proactively incorporating a patient’s personal desires in the treatment plan. Without this agency, patients may feel pressured, disempowered, or disengaged from processes that will directly impact a critical stage of their life. This can lead to regret, apprehension, and even non-adherence to treatment.

Although not conclusive, many studies suggest that shared decision-making in cancer cases has the potential to enhance patient understanding, reduce anxiety, and strengthen trust. But regardless of whether healthcare providers utilize patient decision-making tools or other SDM strategies, one powerful statistic is reflected in these studies:

Patients almost never want to make these decisions alone.

Key Principles of Shared Decision-Making

SDM is a process, not an event. Conversations about a cancer care plan can also evolve as new information is discovered and emotions shift.

When engaging in shared decision-making for cancer care, healthcare workers should seek to balance:

• Respect for patient autonomy. Patients should be empowered to make informed choices, even when those differ from the provider’s recommendation.
• Evidence-based communication. Clinicians must clearly present benefits, risks, and uncertainties using plain language and decision aids when necessary.
• Collaborative partnership. Both provider expertise and patient lived experience are essential for effective care. Providers bring medical knowledge; patients bring values, goals, and personal context.
• Emotional support. Cancer decisions are emotionally charged. Acknowledging fears and feelings is as vital as presenting data.

Steps for Implementing SDM in Cancer Care

While outcomes will vary from patient to patient, healthcare providers can provide a structured approach to the process.

1. Prepare the Groundwork

Before engaging in shared decision-making, providers should assess the patient’s readiness and preferences for involvement. Some patients will prioritize detailed participation, while others prefer a more guided approach.

Many people can feel completely overwhelmed at the thought of having to make any decision after a cancer diagnosis, so asking straightforward questions like, “How much do you want to be involved in making this decision?” helps set the stage.

2. Present Options Clearly

When presenting treatment pathways, avoid medical jargon. Instead of saying “cytotoxic chemotherapy,” explain it as “This is a type of treatment that kills cancer cells but also affects healthy cells. This can cause side effects like fatigue and nausea.” Use visuals, charts, or written summaries when possible.

3. Discuss Benefits and Risks Transparently

Balance optimism with honesty. Patients should understand both potential benefits and realistic risks.

For instance, saying something like “This treatment may extend life by several months, but there is a high chance of hospitalization due to side effects,” sets realistic expectations. Additionally, presenting risks in terms of true numbers rather than percentages can enhance comprehension.

4. Explore Patient Values and Preferences

At the heart of shared decision-making is an appreciation and assessment of the patient’s values and preferences. Start by asking open-ended questions like:

• “What matters most to you—living as long as possible, or prioritizing quality of life?”
• “Are there side effects that you feel would be unacceptable?”
• “How do your family, work, or cultural beliefs influence this decision?”

Based on their answers, you may identify opportunities for additional patient education and explanation. Ultimately, you’ll gather valuable information that should be documented to ensure it remains central to ongoing care.

5. Deliberate Together

Make sure patients know it’s OK to take the time to consider their options, seek input from loved ones, and return with questions. This step requires patience and sometimes multiple conversations. During this time, it may be good to offer resources like patient navigators for guidance.

6. Reach a Shared Decision & Revisit Over Time

Once options have been explored, confirm the decision together. Use phrases like, “Based on what you’ve told me about your priorities, this treatment seems to align with your goals. How do you feel about moving forward?”

This prevents any doubt in the next steps. Also, appreciate that what feels right in the moment may not feel right to them months later. Regularly checking in to reassess goals, especially if the disease progresses or new treatments emerge, is essential.

Tips for Healthcare Providers

Whether you’re an oncology specialist or simply providing routine screening in general practice, every healthcare provider can benefit from the following best practices when it comes to shared decision-making in cancer care:

• Use decision aids. Evidence-based tools, such as brochures or interactive apps, help simplify complex trade-offs.
• Practice active listening. Repeat back what patients share to confirm understanding.
• Mind cultural sensitivity. Decision-making styles vary, and some patients prefer involving extended family or religious leaders.
• Take your time. While the conversations that accompany shared decision-making can feel time-consuming, they often save time in the long run by reducing confusion, repeated explanations, and treatment non-adherence.
• Address emotions openly. Simply acknowledging a patient’s fear or uncertainty can strengthen trust and confidence.

Compassionate Shared Decision-Making in Cancer Care

Cancer care decisions can be among the heaviest that patients and families will ever face. Shared decision-making in cancer care transforms a provider-driven process into a collaborative journey, ensuring that every decision reflects not just medical expertise but also the human experience of living with cancer.

Premiere is committed to helping healthcare workers connect with their patients and promote decisions around cancer care that reflect ideal outcomes for everyone in the equation. Courses like Screening Survival: Navigating the World of Cancer Care provide concrete tips and strategies for making these conversations meaningful, compassionate, and empowering.

All of Premiere’s award-winning courses are developed by industry experts and help healthcare workers meet their professional obligations and develop their careers on a timeline that matches their busy schedule.

FAQs

What is shared decision-making in cancer treatment?

Shared decision-making empowers patients and their families to incorporate medical realities with personal values, cultural contexts, and emotional burdens as they navigate difficult care choices. By listening carefully, healthcare professionals can work together to craft a care plan that aligns with individual priorities.

What is an example of shared decision-making in healthcare?

Rather than pressuring people to adopt a care plan that reflects objective medical evidence, care providers should proactively engage with their patients and families to identify their preferences and priorities.

Questions such as, “This treatment may extend life by several months, but there is a high chance of hospitalization due to side effects,” provide a realistic assessment in a framework for making informed personal decisions.

What is the most important reason for practicing shared decision-making?

Current evidence-based research suggests that shared decision-making in cancer care may enhance patient understanding, reduce anxiety, strengthen trust, and increase adherence to treatment plans.

What are the three key elements of shared decision-making?

Healthcare professionals involved in shared decision-making in cancer care should transparently discuss benefits and risks, deliberate with patients over their preferences, and revisit these choices as treatment progresses.