Abstract
Background
Prostate cancer (PCa) is the most prevalent male-specific cancer worldwide. Treatment options, despite being highly effective in treating the disease are related to significant decreases in sexual, urinary, and bowel function. Advancement in screening techniques have led to an increase in the numbers of men diagnosed with lower-risk PCa which has resulted in potential overtreatment of lower-risk patients. A monitoring strategy known as Active Surveillance (AS) has been developed in response to this, an approach that allows men to delay or avoid treatment until the disease progresses further to preserve quality of life.
Methods
As part of a larger longitudinal, quantitative study exploring the psychological impact of diagnosis of lower-risk PCa in newly diagnosed patients, those who had opted for AS were invited to participate in a semi-structured interviews 9-12 months post-diagnosis to further explore their experiences of diagnosis and monitoring via AS. Eleven participants were invited, 10 agreed to participate from which 9 interviews were completed. Mean age of participants was 67 years (range 60-77). Interviews lasted mean 47 minutes (range 29-78).
Results
Three themes were identified: ‘Difficulty Processing Diagnosis’; ‘The ‘Inactive’ Nature of AS’; and ‘(Dis)Trust of Health Care Professionals’. Cognitive-emotional dissonance was a strong feature of all interviews conducted. Participants “see-sawed” between demonstrating an understanding of the favourable nature of their diagnosis, citing their low risk of disease progression while continuing to describe profound fear, uncertainty, and a sense of inevitability of a PCa-related death.
Conclusions
Data suggests that AS patients interviewed had not integrated the low risk of progression emotionally in spite of their ability to accurately describe their objective risk. This is particularly significant for HCPs, who may assume their patients’ ability to accurately articulate their risk of progression is an indicator of the patient internalising and understanding this message on an emotional level.
Prostate cancer (PCa) is the most prevalent male-specific cancer worldwide. Treatment options, despite being highly effective in treating the disease are related to significant decreases in sexual, urinary, and bowel function. Advancement in screening techniques have led to an increase in the numbers of men diagnosed with lower-risk PCa which has resulted in potential overtreatment of lower-risk patients. A monitoring strategy known as Active Surveillance (AS) has been developed in response to this, an approach that allows men to delay or avoid treatment until the disease progresses further to preserve quality of life.
Methods
As part of a larger longitudinal, quantitative study exploring the psychological impact of diagnosis of lower-risk PCa in newly diagnosed patients, those who had opted for AS were invited to participate in a semi-structured interviews 9-12 months post-diagnosis to further explore their experiences of diagnosis and monitoring via AS. Eleven participants were invited, 10 agreed to participate from which 9 interviews were completed. Mean age of participants was 67 years (range 60-77). Interviews lasted mean 47 minutes (range 29-78).
Results
Three themes were identified: ‘Difficulty Processing Diagnosis’; ‘The ‘Inactive’ Nature of AS’; and ‘(Dis)Trust of Health Care Professionals’. Cognitive-emotional dissonance was a strong feature of all interviews conducted. Participants “see-sawed” between demonstrating an understanding of the favourable nature of their diagnosis, citing their low risk of disease progression while continuing to describe profound fear, uncertainty, and a sense of inevitability of a PCa-related death.
Conclusions
Data suggests that AS patients interviewed had not integrated the low risk of progression emotionally in spite of their ability to accurately describe their objective risk. This is particularly significant for HCPs, who may assume their patients’ ability to accurately articulate their risk of progression is an indicator of the patient internalising and understanding this message on an emotional level.
| Original language | English |
|---|---|
| Publication status | Accepted - 2018 |
| Event | British Psychological Society - Male Psychology Conference - University College London, London, United Kingdom Duration: 22 Jun 2018 → 23 Jun 2018 |
Conference
| Conference | British Psychological Society - Male Psychology Conference |
|---|---|
| Abbreviated title | BPS Male Psychology Conference |
| Country/Territory | United Kingdom |
| City | London |
| Period | 22/06/2018 → 23/06/2018 |
