title: Cognitive and Affective Representations of Active Surveillance as a Treatment Option for Low-Risk Prostate Cancer.
abstract: Benefits of early diagnosis and treatment remain debatable for men with low-risk prostate cancer. Active surveillance (AS) is an alternative to treatment. The goal of AS is to identify patients whose cancer is progressing rapidly while avoiding treatment in the majority of patients. The purpose of this study was to explore cognitive and affective representations of AS within a clinical environment that promotes AS a viable option for men with low-risk prostate cancer. Participants included patients for whom AS and active treatment were equally viable options, as well as practitioners who were involved in consultations for prostate cancer. Data were generated from semistructured interviews and audits of consultation notes and were analyzed using thematic analysis. Nineteen patients and 16 practitioners completed a semistructured interview. Patients generally viewed AS as a temporary strategy that was largely equated with inaction. There was variation in the degree to which inaction was viewed as warranted or favorable. Patient perceptions of AS were generally malleable and able to be influenced by information from trusted sources. Encouraging slow deliberation and multiple consultations may facilitate greater understanding and acceptance of AS as a viable treatment option for low-risk prostate cancer.
authors.affiliation: 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Lyons
authors.affiliation: 2 SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Hsin H
authors.initials: HH
authors.lastname: Li
authors.affiliation: 2 SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Mader
authors.affiliation: 2 SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Telisa M
authors.initials: TM
authors.lastname: Stewart
authors.affiliation: 2 SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Morley
authors.affiliation: 2 SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Formica
authors.affiliation: 3 University of Vermont College of Medicine, Burlington, VT, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Perrapato
authors.affiliation: 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Seigne
authors.affiliation: 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Elias S
authors.initials: ES
authors.lastname: Hyams
authors.affiliation: 3 University of Vermont College of Medicine, Burlington, VT, USA.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Irwin
authors.affiliation: 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Mosher
authors.affiliation: 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hegel
keywords: active surveillance; choice behavior; decision making; prostatic neoplasm; qualitative research