Shared decision making in neuro-oncology: existing practices and future steps

“It’s about YOUR life, and of course, YOU should have a say in the decision.” This statement was made by a patient with recurrent high-grade glioma concerning the decision-making about treatment for her recurrence.1 While she deeply valued the expertise and experience of the neurosurgeon with whom she discussed the treatment options, it was crucial for her to feel actively involved in the decision-making and that her values and preferences were included and respected. This is the essence of shared decision-making (SDM).

As the example illustrates, sharing decisions requires attentiveness and interest in the patient’s perspective and a willingness to accept that the best decision for the individual patient might not be identical to the decision the clinician would have made. On a more practical note, SDM entails making the patient and their family aware that there is a choice, providing them with evidence-based and tailored information about the options, eliciting and discussing the patient’s preferences and values, and, finally, reaching a shared decision.2