Patient-Centered Communication of Life Expectancy Estimates in Genitourinary Malignancies

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Cedars-Sinai Medical Center




Prostate Cancer Stage II
Kidney Cancer Stage I
Prostate Cancer Stage I
Bladder Cancer Stage II


Behavioral: Patient-centered communication of life expectancy

Study type


Funder types




Details and patient eligibility


Investigators will conduct a randomized trial to determine if providing patient-specific life expectancy estimates during treatment counseling via a targeted, patient-centered communication approach improves shared decision making and reduces rates of overtreatment of genitourinary malignancies.

Full description

Subjects in the intervention arm will be provided with life expectancy estimates specific to their age and health status. Life expectancy estimates for prostate and kidney cancer patients will be estimated by age and Charlson comorbidity score cutoffs, and life expectancy for bladder cancer patients will be determined using definitions as noted by Cho et al. Talking points will be provided to counseling physicians on how to meaningfully communicate life expectancy data. Subjects will also complete a computer-based conjoint analysis exercise prior to the counseling visit; results will be used to help physicians understand how the subject values life expectancy compared with other decision attributes. The control arm will consist of the current standard of care for treatment counseling. The intervention will be randomized at the level of the patient after stratification by type of cancer. All participants will be asked to fill out a validated questionnaire to measure decisional conflict at the conclusion of their counseling visit. Investigators will audiotape treatment counseling visits to allow for qualitative analysis of the quality of communication of life expectancy information. Treatment choice will be documented to assess rates of aggressive versus non-aggressive treatment among patients with limited life expectancy.


136 estimated patients




18+ years old


No Healthy Volunteers

Inclusion criteria

  • Newly diagnosed clinical T1-2 prostate adenocarcinoma with Gleason scores of 7 or less
  • Newly diagnosed clinical T1a kidney cancer or renal masses < 4cm
  • Newly diagnosed clinical T2 nonmetastatic urothelial carcinoma of the bladder

Exclusion criteria

  • Under 18 years of age
  • Subjects with difficulty communicating or dementia
  • Non-English speakers

Trial design

Primary purpose

Health Services Research



Interventional model

Parallel Assignment


None (Open label)

136 participants in 2 patient groups

Intervention Arm
Experimental group
Intervention: (1) Subjects will be provided with patient-specific LE estimates, (2) counseling physicians will receive "talking points" to assist in meaningful communication of life expectancy, and (3) subjects will complete a computer-based conjoint analysis exercise prior to counseling.
Behavioral: Patient-centered communication of life expectancy
Standard-of-care Arm
No Intervention group
Patients in the standard-of-care arm will not receive an intervention and will receive the usual standard of care for treatment counseling.

Trial contacts and locations



Central trial contact

Timothy Daskivich, MD, MSHPM

Data sourced from

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