Why men with a low-risk prostate cancer select and stay on active surveillance: A qualitative study

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Seaman, Aaron T. ; Taylor, Kathryn L. ; Davis, Kimberly ; Nepple, Kenneth G. ; Lynch, John H. ; Oberle, Anthony D. ; Hall, Ingrid J. ; Volk, Robert J. ; Reisinger, Heather Schacht ; Hoffman, Richard M.
• Description:
  Objective
  
  Active surveillance (AS) is an increasingly utilized strategy for monitoring men with low-risk prostate cancer (PCa) that allows them to defer active treatment (AT) in the absence of cancer progression. Studies have explored reasons for selecting AS and for then switching to AT, but less is known about men’s experiences being on AS. We interviewed men to determine the clinical and psychological factors associated with selecting and adhering to AS protocols.
  
  Methods
  
  We conducted semi-structured interviews with men with a low-risk PCa at two academic medical centers. Subjects had either been on AS for ≥ 1 year or had opted for AT after a period of AS. We used an iterative, content-driven approach to analyze the interviews and to identify themes.
  
  Results
  
  We enrolled 21 subjects, mean age 70.4 years, 3 racial/ethnic minorities, and 16 still on AS. Men recognized the favorable prognosis of their cancer (some had sought second opinions when initially offered AT), valued avoiding treatment complications, were reassured that close monitoring would identify progression early enough to be successfully treated, and trusted their urologists. Although men reported feeling anxious around the time of surveillance testing, those who switched to AT did so based only on evidence of cancer progression.
  
  Conclusions
  
  Our selected sample was comfortable being on AS because they understood and valued the rationale for this approach. However, this highlights the importance of ensuring that men newly diagnosed with a low-risk PCa are provided sufficient information about prognosis and treatment options to make informed decisions.
  
  
• Subjects:
  Aged, 80 And Over Chronic Disease Indicators Health Knowledge, Attitudes, Practice Humans Male Middle Aged Patients Prostatic Neoplasms
• Source:
  PLoS One. 14(11)
• Pubmed ID:
  31747396
• Pubmed Central ID:
  PMC6867634
• Document Type:
  Journal Article
• Funding:
  U48 DP005017/DP/NCCDPHP CDC HHS/United States
• Volume:
  14
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:69f54ccd9c9f1a97c736c23673620a98cbfce900ded523ea0eebb7e126ae0099
• Download URL:
  https://stacks.cdc.gov/view/cdc/89642/cdc_89642_DS1.pdf
• File Type:
  [PDF - 442.74 KB ]