Decision-Making in Prostate Cancer: Active Surveillance Over Other Treatment Options

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

Identify how patients diagnosed with prostate cancer (PCa) choose active surveillance (AS) over other treatment options.

Methods

A qualitative-descriptive investigation was undertaken using semi-structured interviews. The Cognitive-Social Health Information Processing (C-SHIP) model was used as the framework to guide the interviews. Four patients who had been recruited through purposive sampling and were essentially healthy young men who had chosen active surveillance were recruited. Interviews were audio recorded and transcribed. Major themes as presented by patients were coded and grouped, then analyzed using the C-SHIP model as a framework for content analysis.

Results

In accordance with the literature, the surgeon or general practitioner's recommendation was the most influential factor when making a decision. Being able to trust the doctor was important; although all patients denied researching different treatments, they all researched the surgeon both electronically and by word of mouth. When deciding on a treatment, patients discussed the need to consider potential side effects, and the avoidance of these was often a significant factor when deciding whether to pursue active surveillance or other forms of treatment. All patients placed a high value on their sexual health, thus avoiding erectile dysfunction (ED) was an important factor. This study demonstrates that more qualitative research should be done with patients who have PCa, specifically in the area of decision-making. This appears especially significant because there is no gold standard treatment option available.

Conclusion

The recommendation of the physician was the most influential factor in a patient's decision making process. Patients must therefore feel that they are able to trust the physician; this was based on having a good relationship with the physician, and was generally not based on the surgeon's level of expertise. Patients received a majority of their information about the surgeon and treatment options by way of anecdotal recommendations from trusted family and friends who do not necessarily have experience with PCa. The decision to undergo active surveillance was also heavily influenced by their desire to avoid or delay the side effects associated with invasive therapies, especially that of ED.

Level of Evidence - VI

(Polit & Beck, 2012)

Level of Evidence - VI

A qualitative-descriptive study of four patients with prostate cancer used the Cognitive-Social Health Information Processing framework to understand how and why men diagnosed with prostate cancer choose active surveillance over other treatment options. In accordance with the literature, it was found that the surgeon or general practitioner's recommendation was the most influential factor when patients are making a treatment decision.

Related Topics

    loading  Loading Related Articles