Conversion from active surveillance to active treatment for prostate cancer: A qualitative analysis

Kazer, Meredith Wallace

doi:10.5430/jnep.v2n2p80

Cited by 5 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twenty‐three papers were included, 20 quantitative and 3 qualitative . Nine were longitudinal with a follow‐up period ranging from 9 months to 3 years .…”

Section: Resultsmentioning

confidence: 99%

“…Four of the 9 longitudinal studies had follow‐up response rates of >70%, whereas others reported more conservative follow‐up response rates of <60% . Fourteen were cross‐sectional, with time since diagnosis ranging from 2 months to 136 months . Six papers referring to WW, yet providing definitions for AS, ie, not palliative care, were included .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Active surveillance for favorable‐risk prostate cancer: Is there a greater psychological impact than previously thought? A systematic, mixed studies literature review

et al. 2016

View full text Add to dashboard Cite

ObjectiveActive Surveillance (AS) allows men with favourable-risk prostate cancer (PCa) to avoid or postpone active treatment and hence spares potential adverse side effects for a significant proportion of these patients. Active surveillance may create an additional emotional burden for these patients.The aim of the review was to determine the psychological impact of AS to inform future study in this area and to provide recommendations for clinical practice. MethodsStudies were identified through database searching from inception to September 2015.Quantitative or qualitative non-interventional studies published in English that assessed the psychological impact of AS were included. The Mixed Methods Appraisal Tool was used to assess methodological quality. ResultsTwenty-three papers were included (20 quantitative, 3 qualitative). Quantitatively, the majority of patients do not report psychological difficulties, however when appropriateness of study design is considered, the conclusion that AS has minimal impact on wellbeing, may not be accurate. This is due to small sample sizes, inappropriately timed baseline, and inappropriate/lack of comparison groups. In addition, a mismatch in outcome was noted between the outcome of quantitative and qualitative studies in uncertainty, with qualitative studies indicating a greater psychological impact. ConclusionsDue to methodological concerns, many quantitative studies may not provide a true account of the burden of AS. Further mixed-methods studies are necessary to address the limitations This article is protected by copyright. All rights reserved.highlighted and to provide clarity on the impact of AS. Practitioners should be aware that despite findings of previous reviews, patients may require additional emotional support.

show abstract

“…Twenty‐three papers were included, 20 quantitative and 3 qualitative . Nine were longitudinal with a follow‐up period ranging from 9 months to 3 years .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Active surveillance for favorable‐risk prostate cancer: Is there a greater psychological impact than previously thought? A systematic, mixed studies literature review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…31 Our findings are broadly consistent with previous quantitative studies 9-13 but appear to differ from some previous qualitative research that reports persistent worry, altered social activities, and greater psychological needs in men on AS/WW. [15][16][17][18] These studies were, however, based on much smaller samples of men on WW (less than 10 participants), 15,16 those who switched from AS to AT 18 or focused on men closer to diagnosis. Men in our sample were 18 to 42 months post diagnosis, and it is possible those initially on AS experiencing greater anxiety had opted for AT within the study time frame.…”

Section: Discussionmentioning

confidence: 99%

“…Systematic reviews of quantitative studies suggest that quality of life and psychological well‐being in men on AS/WW are generally good and comparable with, or better than, men who received AT. However, evidence from qualitative studies suggests that men on AS/WW may struggle with anxiety . Further exploration is needed to understand how men adjust to being on AS/WW.…”

Section: Introductionmentioning

confidence: 99%

“…However, evidence from qualitative studies suggests that men on AS/WW may struggle with anxiety. [15][16][17][18][19][20] Further exploration is needed to understand how men adjust to being on AS/WW. The Life After Prostate Cancer Diagnosis (LAPCD) study is a UKwide mixed methods study, 21 which aimed to explore the impact of PCa on men's well-being through a large-scale survey of men with PCa and interviews with a subsample.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The psychological impact of being on a monitoring pathway for localised prostate cancer: A UK‐wide mixed methods study

et al. 2019

View full text Add to dashboard Cite

Objective To address concerns over the psychological impact of being on a monitoring pathway following prostate cancer (PCa) diagnosis, this study compared the psychological status of men on active surveillance (AS) or watchful waiting (WW) with men on active treatment (AT) and explored psychological adjustment in men on AS/WW. Methods Cross‐sectional survey of UK men diagnosed with PCa 18 to 42 months previously (n = 16 726, localised disease at diagnosis) and telephone interviews with 24 men on AS/WW. Psychological outcomes were measured using two validated scales (Short Warwick‐Edinburgh Mental Well‐being Scale [SWEMWBS] and Kessler Psychological Distress Scale). Univariable and multivariable analyses compared outcomes between men on AS/WW and AT. Thematic analysis of interviews was undertaken, informed by a previously developed theory of adjustment to cancer. Results A total of 3986 (23.8%) respondents were on AS/WW. Overall, psychological outcomes were similar or better in men on AS/WW compared with those receiving AT (SWEMWBS: Poor well‐being; 12.3% AS/WW vs 13.9% AT, adjusted OR = 0.86, 95% CI, 0.76‐0.97; K6: severe psychological distress; 4.6% vs 5.4%, adjusted OR = 0.90, 95% CI, 0.74‐1.08). Interviews indicated that most men on AS/WW had adjusted positively. Men with poorer well‐being were less able to accept, reframe positively and normalise their diagnosis, described receiving insufficient information and support, and reported a lack of confidence in their health care professionals. Conclusions Most men on AS/WW cope well psychologically. Men making treatment decisions should be given this information. Psychological health should be assessed to determine suitability for AS/WW, and at monitoring appointments. A clear action plan and support from health care professionals is important.

show abstract

The experiences of men on active surveillance for prostate cancer and their significant others: A qualitative synthesis

Hughes,

Everitt,

Stuart

et al. 2024

Psycho-Oncology

View full text Add to dashboard Cite

BackgroundActive surveillance (AS) for prostate cancer (PCa) is a monitoring pathway for men with low‐grade, slow growing PCa and aims to delay or avoid active treatment by treating only in the case of disease progression. Experiences of this pathway vary but living with an untreated cancer can have a negative psychological impact on both the patient and their significant other (SO). Literature suggests partners are the primary source of support for men on AS, and therefore it is important to consider SO experiences alongside those of the patient. To the best of our knowledge this is the first UK‐based qualitative review looking specifically at experiences of AS for both men with PCa and their SOs.MethodsMEDLINE (Ovid), EMBASE, PsychINFO, CINAHL and Cochrane Library were searched for literature reporting qualitative experiences of AS for PCa for either men on AS or SOs (or both). 2769 records were identified and screened, with 28 meeting the eligibility criteria. Qualitative data were synthesised and included men on AS (n = 428), and SOs (n = 51).ResultsExperiences of the AS pathway vary but reports of uncertainty and anxiety were present in the accounts of both men on AS and SOs. SOs are intertwined throughout every part of the PCa journey, and couples presented as a unit that were on AS together. Both patients and SOs expressed a need for more support, and highly valued peer support. Despite this finding, men expressed a dislike towards ‘support groups’.ConclusionsIncreased recognition in clinical practice of SO involvement in AS is needed. Further research is required to explore the specific types of support that would be most acceptable to this population to address the unmet support needs uncovered in this review.

show abstract

Conversion from active surveillance to active treatment for prostate cancer: A qualitative analysis

Cited by 5 publications

References 22 publications

Active surveillance for favorable‐risk prostate cancer: Is there a greater psychological impact than previously thought? A systematic, mixed studies literature review

Active surveillance for favorable‐risk prostate cancer: Is there a greater psychological impact than previously thought? A systematic, mixed studies literature review

The psychological impact of being on a monitoring pathway for localised prostate cancer: A UK‐wide mixed methods study

The experiences of men on active surveillance for prostate cancer and their significant others: A qualitative synthesis

Contact Info

Product

Resources

About