With the American Cancer Association predicting the diagnosis of over 186,000 new cases of prostate cancer in 2008 alone, the importance of patients having comprehensive and accessible information about their disease and choice of treatment options is heightened to a new level. However, prostate cancer is unique among chronic diseases in that of all the treatments available, no one has been proven more or less successful in extending life. The lack of a clear optimal treatment option leaves patients with a confusing and uncertain choice of how to deal with their disease.

In light of this uncertaintly, The Abramson Center has developed and interactive website called Time After Time, which attempts to change the way in which men approach and experience decision making for treatment of early-stage prostate cancer. Utilizing the complementary decision theories of Satisficing and Info-Gap, both of which reduce uncertainty while increasing the robustness of decision making, Time After Time works to imform patients and facilitate the dfificult choices they must make when first diagnosed with early-stage prostate cancer. The ultimate goal of using the website is to provide a substantial jumping off point for a more productive conversation with the patient's physician.

The website is based in the reality of prostate cancer treatments - with no intervention proven to extend life the most, side effect variation in the short and long term becomes a more important factor in choosing a treatment. The Time After Time website uses probability data comparing the short ad long term side effects of four major treatments for prostate cancer: brachytherapy, radical prostatectomy, external radiotherapy, and watchful waiting. Dr. Martin Sanda's study published in the March 2008 issue of The New England Journal of Medicine documents the effects of each treatment option, demostrating the chance of experiencing different types of side effects following particular forms of intervention. Although important and useful, the data are hard for most patients to interpret and use in decision-making. Time After Time works to translate these complicated probability data into a format that utilizes the idea of chance associated with slot machines, a concept that is both readily accsesible and easy to comprehend for the nonmedical user.

Using the website, which focuses on four major side effect domains (urinary, bowel, sexual and urinary control), allows patients to "experience" a firsthand simulation of different treatment options and side effects, as they might occur after one week, two months, and twelve months. The user rates these side effects according to their preferences, allowing the program to use these ratings to assess the treatment option that would provide them the most long term satisfaction. Through this procses, we hope to educate patients by exposing them to the long term realities of choosing one of the four main treatments profiled, and facilitate a discussion with their physicians that will ultimately lead to a decision that will provide the best results for the patient and his family.