No abstract

Within the UK, prostate cancer is now the most common cancer in men. Treatments for prostate cancer are associated with short‐term and long‐term side effects. Previous research in this area has mainly concentrated on symptom severity in relation to quality of life and has been largely quantitative in nature. The aim of this research study was to explore the perception and meaning of symptoms experienced by men with prostate cancer, from the patients' perspective. Ten men with newly diagnosed prostate cancer, undergoing treatment, were interviewed four times over 1 year. Interviews were analysed using an analytic framework underpinned by the common sense model. The men tended to minimize their symptom experience and cancer diagnoses over all four interviews. They were less likely to minimize symptoms if they believed their symptoms might be due to disease progression. Men appeared passive in their care and reluctant to ask questions; they did not appear to understand post‐treatment follow‐up procedures and this led to feelings of abandonment. This study is one of the only studies to explore how men perceive, appraise and manage symptoms related to prostate cancer over the first year after diagnosis. This may help health professionals when planning interventions and services for men with prostate cancer. Passivity in care appeared related to information deficits; patients need to be empowered to become active partners in their care.

To examine the experiences of patients and healthcare professionals of prostate cancer follow-up in primary care and to identify areas where current policy and practice could be improved. Methods: Semi-structured interviews with patients, GPs and oncologists explored experiences of prostate cancer follow-up. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. The three participant groups were analysed as individual datasets but the same key themes were evident across the groups. Results: 14 patients, 6 GPs and 5 oncologists were interviewed. Four main themes were identified: Experience of current practice; Knowledge and understanding of prostate cancer follow up; Disparity of processes and pathways; Unclear roles and responsibilities. Conclusions: Findings from this study highlight the variation in the approach to prostate specific antigen monitoring and emphasise the lack of clear policies and practices. The lack of clarity around existing follow up and monitoring processes could cause delays in the diagnosis of recurrence. There is a need for a new and improved pathway for prostate cancer follow up. The pathway should include clear and concise guidance for patients, primary care and secondary care and all relevant parties need to understand what their role is within the pathway.

Since the 1990s, the incidence of prostate cancer in the UK has increased by 41% (Cancer Research UK, 2019). With advances in new prostate cancer treatments, men can now live for many years on and after treatment (Cancer Research UK, 2019). The ageing population and further medical developments mean the number of survivors is likely to increase further, putting a considerable pressure on urology and oncology outpatient clinics to provide aftercare (Yip et al., 2015).Prostate cancer patients often require lifelong prostate-specific antigen (PSA) surveillance (Warr et al., 2016). It is recognised that a rise in PSA blood levels following primary treatment is usually the first indicator of disease recurrence before presentation of any clinical symptoms (Hennessey et al., 2013). Despite improvements in treatment outcomes and survival times, it is estimated that disease recurs in between 27-53% of men who have had prostatectomy or radiotherapy (Mottet et al., 2019).Post-treatment PSA surveillance is a crucial step in identifying recurrence and offering subsequent treatment. There are however