Undergoing radical treatment for prostate cancer and its impact on wellbeing: A qualitative study exploring men’s experiences

Abstract

Introduction Quality of life in prostate cancer survivorship is becoming increasingly important, with mental and social wellbeing recognised as key components. However, limited global evaluation of psychosocial challenges experienced after treatment exists. Therefore, we aimed to explore the lived experiences of men who underwent radical treatment, and its psychosocial impact. Material and methods This qualitative study was conducted using 19 men who had undergone radical treatment (prostatectomy or radiotherapy) for their cancer. Semi-structured interviews were conducted exploring lived experiences of men after treatment. A Structured thematic analysis of collected data was undertaken, with an inductive co-construction of themes through the lens of the biopsychosocial model. Themes generated were considered within a psychological, social, and physical wellbeing framework. Results An initial knowledge gap meant mental wellbeing was strongly impacted initially leading to a ‘Diagnostic Blow and the Search for Clarity’. Doubt over individuals’ future resulted in ‘An Uncertain Future’ in many men. Once treatment was completed a ‘Reflective journey’ began, with men considering their outcomes and decisions made. Social wellbeing was also impacted with many identifying the ‘Emotional Repercussions’ on their relationships and the impact their diagnosis had on their partner and family. Many subsequently sought to increase their support through ‘The Social Network and Advocacy’, while physical changes led to an increased need for ‘Social Planning’. Finally, physical wellbeing was highlighted by a continual acknowledgement of the ‘Natural process of ageing’ leading to a reluctancy to seek help, whilst simultaneously attempting to improve existing health via ‘The Health Kick’. Conclusions Radical treatments have a considerable impact on mental and social wellbeing of individuals. Anxiety after diagnosis and significant uncertainty over individual futures exist, with physical complications of treatment leading to social repercussions. Future research should aim to identify forms of support to improve quality of life of these men.

Prognostic factors for mental wellbeing in prostate cancer: A systematic review and meta‐analysis

“…When considering the review itself, limitations include the inability to provide a statistical synthesis for the vast majority of factors and outcomes within the study, largely due to the heterogeneity highlighted previously meaning such a synthesis would not be appropriate. Additionally, this review sought to evaluate five specific mental wellbeing outcomes, these selected as they were seen to be important from previous literature reviews and patient views conducted as background work 26 . However, mental wellbeing is a broad and dynamic concept with varying definitions of what this constitutes within PC 8 This meant that other potentially important constructs were not specifically evaluated including distress/cancer‐specific distress, cancer‐specific distress/emotional distress, broader mental health/wellbeing measures (as is used in the Short Form 12 or 36 or other health related quality of life measures), and other mental health diagnoses (such as serious mental illnesses).…”

“…Additionally, this review sought to evaluate five specific mental wellbeing outcomes, these selected as they were seen to be important from previous literature reviews and patient views conducted as background work. 26 However, mental wellbeing is a broad and dynamic concept with varying definitions of what this constitutes within PC 8 This meant that other potentially important constructs were not specifically evaluated including distress/cancer‐specific distress, cancer‐specific distress/emotional distress, broader mental health/wellbeing measures (as is used in the Short Form 12 or 36 or other health related quality of life measures), and other mental health diagnoses (such as serious mental illnesses). Many of these were excluded due to their often broad or varying definitions within the literature, overlapping nature with selected outcomes, or reduced frequency within the population of interest.…”

“…8 Therefore, multiple separate reviews and qualitative patient interviews were conducted, with a triangulation approach of these in combination used to better define this, selecting outcomes seen to be prevalent, severe and of importance to patients leading to five outcomes being selected as set out in this review. 7 , 11 , 18 , 25 , 26 …”

“…Additionally, this review sought to evaluate five specific mental wellbeing outcomes, these selected as they were seen to be important from previous literature reviews and patient views conducted as background work. 26 health diagnoses (such as serious mental illnesses). Many of these were excluded due to their often broad or varying definitions within the literature, overlapping nature with selected outcomes, or reduced frequency within the population of interest.…”

“…8 Therefore, multiple separate reviews and qualitative patient interviews were conducted, with a triangulation approach of these in combination used to better define this, selecting outcomes seen to be prevalent, severe and of importance to patients leading to five outcomes being selected as set out in this review. 7,11,18,25,26 No restrictions were set on post-diagnosis timing with any clinical setting included. Studies had to utilise either a previously validated psychometric tool to assess the outcome of interest, or diagnostic coding data following clinical diagnosis for depression and anxiety outcomes.…”