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Patient‒HCP Communication Gaps
Gaps in Patient‒HCP Communication Shown via Survey of Patients With Prostate Cancer

Released: June 07, 2023

Alicia Morgans
Alicia Morgans, MD, MPH
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Key Takeaways
  • In a survey of patients with metastatic prostate cancer, many patients reported feeling adequately informed about their treatment options.
  • Despite feeling adequately informed, respondents indicated that they did not discuss biomarker testing or some targeted treatment options with their care team.
  • A small percentage of the survey population (11%) identified as non-White or non-Caucasian. 

At the end of April 2023, ZERO Prostate Cancer, a nonprofit patient advocacy organization, along with their educational partner, Clinical Care Options (CCO), surveyed patients on access to and satisfaction with their cancer care. In total, 862 patients completed the survey, with 455 having metastatic disease. Among patients with metastatic disease, 11% self-identified as non-White or non-Caucasian; 90% were 60 years of age and older; and 29% have castration-resistant prostate cancer (CRPC).

The following takeaways were noted from the survey analysis.

  • Only 15% experienced difficulty in accessing care, and 2% indicated difficulty with transportation to clinic.
  • 47% expressed a primary outcome goal of prolonged life, and 46% indicated a primary goal of maintaining quality of life (limiting treatment-related toxicities).
  • 71% felt informed about treatment options.

However, although most patients felt informed about their treatment options, many indicated that they did not have discussions with their care team about biomarker testing or targeted treatment options. Germline genetic testing is recommended by the National Comprehensive Cancer Network and American Urological Association guidelines for all patients with metastatic prostate cancer. With 58% of patients without CRPC and 68% of patients with CRPC reporting discussions about biomarker testing, it appears that these guidelines are not being acted upon uniformly.

When considering treatment conversations, these results suggest that there may be a gap between guideline-recommended treatments and patient-reported understanding. Approximately two thirds of patients without CRPC reported hearing about any of the androgen receptor‒signaling inhibitors that currently are recommended for all patients with metastatic hormone-sensitive prostate cancer in combination with androgen deprivation therapy, in contrast to 94% having discussed androgen deprivation therapy. Numbers increased for patients with CRPC, particularly with abiraterone acetate and enzalutamide. In terms of targeted agents, a minority of patients with CRPC discussed PARP inhibitors as a treatment option vs 46% who discussed lutetium Lu 177 vipivotide tetraxetan. The table below summarizes the percentage of patients who discussed various targeted treatment options with their care teams.


It is important to recognize that patients who responded to this survey had access to and knowledge of online resources and were connected with ZERO Prostate Cancer. This group may be better informed and may have higher health literacy than many patients with prostate cancer in the broader community. Thus, knowledge and understanding of these treatments, testing, and care patterns may be substantially less for a large portion of our prostate cancer community. Bridging the gap in knowledge and ensuring equitable access to the latest treatments and biomarker testing as recommended by guidelines must be a top priority moving forward.

Over the next 6 months, CCO and ZERO Prostate Cancer will be developing educational and clinical resources for healthcare professionals and patients/caregivers covering the latest data and therapeutic options in prostate cancer. Be sure to visit their respective websites frequently for more information and clinical updates.