From "death sentence" to "good cancer": couples' transformation of a prostate cancer diagnosis.
BACKGROUND
While little is known about the couple's process of moving from diagnosis of prostate cancer to treatment, it is acknowledged that cancer-and prostate cancer in particular-affects the couple, not just the patient. This highlighted the need to illuminate this process as a foundation for development of nursing interventions.


OBJECTIVE
To describe the experience of men who are diagnosed with prostate cancer and their wives, from the time of diagnosis through staging to the completion of radical prostatectomy.


METHODS
A qualitative cross-sectional approach was used to elicit couples' experiences from diagnosis to the time of the interview including their response to diagnosis, their treatment decision-making process, and how the couple moved from the decision to have surgery through the staging process to the time that the surgery was completed. A total of 20 couples participated.


RESULTS
Analysis of the data revealed that a number of themes related to the couples' process of moving from diagnosis to treatment. Initially, the diagnosis of prostate cancer represented a loss of control that led these couples to put themselves through a "crash course" on prostate cancer. The information gathered led these couples to conclude that prostate cancer was "good cancer." This enabled them to refocus their energies and start their "quest for the best" treatment and surgeon. Once this was accomplished, the couples began to prepare for surgery that culminated in the turning over of complete control to the surgeon and hospital staff at the time of surgery.


CONCLUSIONS
The participants discovered they were able to manage the demands presented by the intrusion of a cancer diagnosis and mount a response to what at first threatened to be a "death sentence." By engaging in the challenge of gathering a volume of facts and a variety of details, they could make informed decisions. Couples were able to regain a sense of control through the engagement in decision-making related to treatment, surgeon, and hospital, and through the transformation of the meaning of the malignant diagnosis to that of a "good cancer."
Maliski
Sally L
SL
Department of Urology, UCLA Jonsson Comprehensive Cancer Center, Box 956900, Los Angeles, CA 90095-6900, USA. smaliski@mednet.ucla.edu
Heilemann
MarySue V
MV
McCorkle
Ruth
R
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006117:Grief; D006801:Humans; D007258:Informed Consent; D007389:Internal-External Control; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000523:psychology; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D011340:Problem Solving; D011468:Prostatectomy / Q000523:psychology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires