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14 Chapter 1 the patient should always have an active role in evaluating options, information and decision-making, but it does require that the patient is aware that multiple options are available to him and that his personal values and preferences matter for selecting the most appropriate option. This ensures health care is centered around the patient, instead of focusing on the disease or treatment options 9 . Shared decision making (SDM) can help to achieve patient-centered care, as patients become more involved into their medical decision. SDM also contributes to the delivery of appropriate care. That is, when all available options are discussed, and patient values, preferences and circumstances are taken into account, it is more likely that the selected treatment is the optimal treatment for this particular patient, concordant with the individual patient’s values andpreferences and suiting his or her personal circumstances. This ensures that the inevitable scarce resources are allocated appropriately. Benefits from SDM are found on multiple levels. First, there is an ethical imperative related to SDM, consisting of respecting patient autonomy 9 . Second, when being fully informed about all options and personal values have been taken into account, decision outcomes (e.g. chosen treatments) tend to be more conservative 45 . Consequently, SDM contributes to reduce over-treatment and possibly reduces (societal) health costs 46 . As such, SDM may also contribute to the sustainability of our healthcare system. Third, patient-reported outcomes after SDM include less decisional conflict, higher satisfaction with received care, less decisional regret, and better quality of life, although evidence for the latter two outcomes is less conclusive 47 . Procedures in SDM Most SDM models can be translated into three steps towards a final treatment decision and start at the moment when it becomes clear that a decision has to be made 6, 9, 48 . A model that is brief and practical to translate to existing Pca care paths is the Three-talk model, with a Team, Option, and Decision talk 49 . The content of each step is summarized in Figure 3. In Pca care, a multidisciplinary team (e.g., urologist, pathologist, radiologist, radiation oncologist, and oncology nurse) reviews all available evidence from previous tests and consents on what treatments can be considered according to the best available scientific evidence and relevant clinical guidelines. After the patient has received the Pca diagnosis, the aim of the Team talk is to explain all treatment options for which the patient is eligible and to provide additional information materials. Next, the aim of the Option talk is to weigh all benefits and risks from all options against personal patient preferences and values. An oncology nurse is often included in the Pca care