Patient's choice of observational strategy for early-stage prostate cancer

Published on Nov 1, 2012
· DOI :10.7358/NEUR-2012-012-BELL
Lara Bellardita10
Estimated H-index: 10
,
Guendalina Graffigna29
Estimated H-index: 29
(UCSC: Catholic University of the Sacred Heart)
+ 6 AuthorsRiccardo Valdagni51
Estimated H-index: 51
Sources
Abstract
Active Surveillance (AS) may represent for selected patients with low risk, potentially indolent prostate cancer (PCa) a viable alternative to radical therapies, thus reducing the risk of over-treatment. Researchers and clinicians emphasized that the choice of AS may be a controversial one as patients have the chance to avoid the side effects of radical therapies but also the burden of living with an untreated PCa. The aim of our study is to focus on the decision-making process leading patients to elect AS amongst different therapeutic options. An observational, qualitative study was conducted. Between 2007 and 2009, 46 patients (mean age 67 years) were administered a semi-structured interview at enrolment in the Prostate Cancer Research International: Active Surveillance protocol. The focus of the interview was on the first question, i.e. “Why did you choose AS?”. Interviews were audio-recorded and verbatim transcriptions were made. Content analyses were performed by using a text-driven, automatic software (T-lab). Four clusters of themes emerged. In cluster 1, the most meaningful theme was the ambivalence in front of different therapeutic options. In cluster 2, the focus was on patients’ assessment of the aggressiveness of their PCa. In cluster 3, the topic was the collection of information from specialists. In cluster 4, the main theme was the collection of data through informal sources. Patients are motivated to opt for AS based on the subjective evaluation of medical information as well as characteristics of their psycho-social context. Understanding motivation for AS will help clinicians support patients in making the best choice for them. Lara Bellardita et al. Neuropsychological Trends – 12/2012 http://www.ledonline.it/neuropsychologicaltrends/ 108
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Study Type – Therapy (decision analysis) Level of Evidence 2b What's known on the subject? and What does the study add? The benefits of the multidisciplinary approach in oncology are widely recognised. In particular, managing patients with prostate cancer within a multidisciplinarity and multiprofessional context is of paramount importance, to address the complexity of a disease where patients may be offered multiple therapeutic and observational options handled by different specialists and havi...
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