Factors influencing men undertaking active surveillance for the management of low-risk prostate cancer.
OBJECTIVE
To identify and describe decision-making influences on men who decide to manage their low-risk prostate cancer with active surveillance.


METHODS
Qualitative, semistructured interview.


METHODS
The Prostate Centre at Vancouver General Hospital in Canada.


METHODS
25 patients diagnosed with low-risk prostate cancer and on active surveillance.


METHODS
An interpretative, descriptive, qualitative design.


METHODS
Factors that influenced men's decisions to take up active surveillance.


RESULTS
The specialists' description of the prostate cancer was the most influential factor on men choosing active surveillance. Patients did not consider their prostate cancer to be life threatening and, in general, were relieved that no treatment was required. Avoiding treatment-related suffering and physical dysfunction and side effects such as impotence and incontinence was cited as the major reason to delay treatment. Few men actively sought treatment or health-promotion information following their treatment decision. Female partners played a supportive role in the decision. The need for active treatment if the cancer progressed was acknowledged. Patients were hopeful that new treatments would be available when and if they needed them. Being older and having comorbidities did not preclude the desire for future active treatment. Patients carried on with their lives as usual and did not report having any major distress related to being on active surveillance.


CONCLUSIONS
The study findings indicate that men are strongly influenced by the treating specialist in taking up active surveillance and planning future active treatments. As such, most men relied on their specialists' recommendation and did not perceive the need for any adjunct therapy or support until the cancer required active treatment.


CONCLUSIONS
Oncology nurses should work collaborative-ly with specialists to ensure that men receive the information they need to make informed treatment decisions.
Davison
B Joyce
BJ
Department of Urology, University of British Columbia, Prostate Centre at Vancouver General Hospital, Vancouver, Canada. joyce.davison@vch.ca
Oliffe
John L
JL
Pickles
Tom
T
Mroz
Lawrence
L
D000230:Adenocarcinoma / Q000451:nursing / Q000523:psychology* / Q000628:therapy; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D001955:British Columbia; D002755:Choice Behavior; D015897:Comorbidity; D007172:Erectile Dysfunction / Q000523:psychology; D005195:Family Relations; D005239:Fear; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009042:Motivation; D009723:Nurse-Patient Relations; D009859:Oncology Nursing; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology; D011471:Prostatic Neoplasms / Q000451:nursing / Q000523:psychology* / Q000628:therapy