Ep. 278 Shared Decision Making in GU Cancer Management with Dr. Hung-Jui "Ray" Tan

When it comes to GU cancers, fear and uncertainty often shape a patient’s treatment decisions well before the clinical data does. Dr. Hung-Jui (Ray) Tan of UNC Health sits down with host Dr. Ruchika Talwar to unpack why decision-making around small renal masses, low-risk prostate cancer, and other GU conditions can be so challenging. Dr. Tan explains the concept of decisional conflict, a patient’s internal uncertainty about the “right” course of action, and how it predicts downstream satisfaction and health outcomes.

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SYNPOSIS

Dr. Tan shares practical, evidence-based strategies for improving decision-making conversations, from clearer framing to simple visual aids that reduce anxiety. They discuss how patients often perceive much greater risk of metastasis than what data shows, and why “turning down the temperature” is essential before discussing options. They also touch on evolving tools, including AI, that may improve how clinicians communicate risk and support patients through uncertainty.

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TIMESTAMPS

00:00 - Introduction
01:02 - Journey to Decision Science
05:59 - Research on Decision Making
14:41 - Shared Decision Making in Practice
22:39 - Resources for Shared Decision Making
39:54 - Improving Decision-Making Conversations

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RESOURCES

Decisional conflict among patients newly diagnosed with clinical T1 renal masses: a prospective study
https://pmc.ncbi.nlm.nih.gov/articles/PMC11233232/

Decisional Quality in Patients With Small Renal Masses
https://pubmed.ncbi.nlm.nih.gov/29574123/

Impact of renal mass biopsy on decision-making experience for clinical T1 renal masses
https://pubmed.ncbi.nlm.nih.gov/41151063/

MUSIC Patient and Provider Resources for Shared Decision Making
https://musicurology.com/programs/kidney/

P3P - Prostate Cancer Shared Decision Making Resource
https://www.p3p4me.org/users/login

Best Case/Worst Case Treatment Decision Tool
https://patientpreferences.org/best-case-worst-case/

Better Conversations Treatment Decision Tool
https://patientpreferences.org/better-conversations/