Qualitative insights into how men with low-risk prostate cancer choosing active surveillance negotiate stress and uncertainty
Emily M. Mader, [Mader, Emily M.; Li, Hsin H.; Morley, Christopher P.] SUNY Upstate Med Univ, Dept Family Med, 475 Irving Ave,Suite 200, Syracuse, NY 13210 USA; [Li, Hsin H.; Morley, Christopher P.; Formica, Margaret K.; Stewart, Telisa M.] SUNY Upstate Med Univ, Dept Publ Hlth & Prevent Med, 766 Irving Ave,Rm 2262, Syracuse, NY 13210 USA; [Morley, Christopher P.] SUNY Upstate Med Univ, Dept Psychiat & Behav Sci, 750 F Adams St, Syracuse, NY 13210 USA; [Lyons, Kathleen D.; Mosher, Terry; Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Geisel Sch Med Dartmouth, Dept Psychiat, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Perrapato, Scott D.; Irwin, Brian H.] Univ Vermont, Coll Med, Dept Surg, Div Urol, Hetcher House 301,111 Colchester Ave, Burlington, VT 05401 USA; [Seigne, John D.; Hyams, Elias S.] Dartmouth Coll, Dartmouth Hitchcock Med Ctr, Geisel Sch Med, Urol Sect, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Norris Cotton Canc Ctr, Canc Control Program, 1 Med Ctr Dr, Lebanon, NH 03756 USA
Hsin H. Li, [Mader, Emily M.; Li, Hsin H.; Morley, Christopher P.] SUNY Upstate Med Univ, Dept Family Med, 475 Irving Ave,Suite 200, Syracuse, NY 13210 USA; [Li, Hsin H.; Morley, Christopher P.; Formica, Margaret K.; Stewart, Telisa M.] SUNY Upstate Med Univ, Dept Publ Hlth & Prevent Med, 766 Irving Ave,Rm 2262, Syracuse, NY 13210 USA; [Morley, Christopher P.] SUNY Upstate Med Univ, Dept Psychiat & Behav Sci, 750 F Adams St, Syracuse, NY 13210 USA; [Lyons, Kathleen D.; Mosher, Terry; Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Geisel Sch Med Dartmouth, Dept Psychiat, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Perrapato, Scott D.; Irwin, Brian H.] Univ Vermont, Coll Med, Dept Surg, Div Urol, Hetcher House 301,111 Colchester Ave, Burlington, VT 05401 USA; [Seigne, John D.; Hyams, Elias S.] Dartmouth Coll, Dartmouth Hitchcock Med Ctr, Geisel Sch Med, Urol Sect, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Norris Cotton Canc Ctr, Canc Control Program, 1 Med Ctr Dr, Lebanon, NH 03756 USA
Kathleen D. Lyons, [Mader, Emily M.; Li, Hsin H.; Morley, Christopher P.] SUNY Upstate Med Univ, Dept Family Med, 475 Irving Ave,Suite 200, Syracuse, NY 13210 USA; [Li, Hsin H.; Morley, Christopher P.; Formica, Margaret K.; Stewart, Telisa M.] SUNY Upstate Med Univ, Dept Publ Hlth & Prevent Med, 766 Irving Ave,Rm 2262, Syracuse, NY 13210 USA; [Morley, Christopher P.] SUNY Upstate Med Univ, Dept Psychiat & Behav Sci, 750 F Adams St, Syracuse, NY 13210 USA; [Lyons, Kathleen D.; Mosher, Terry; Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Geisel Sch Med Dartmouth, Dept Psychiat, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Perrapato, Scott D.; Irwin, Brian H.] Univ Vermont, Coll Med, Dept Surg, Div Urol, Hetcher House 301,111 Colchester Ave, Burlington, VT 05401 USA; [Seigne, John D.; Hyams, Elias S.] Dartmouth Coll, Dartmouth Hitchcock Med Ctr, Geisel Sch Med, Urol Sect, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Norris Cotton Canc Ctr, Canc Control Program, 1 Med Ctr Dr, Lebanon, NH 03756 USA
Christopher P. Morley, [Mader, Emily M.; Li, Hsin H.; Morley, Christopher P.] SUNY Upstate Med Univ, Dept Family Med, 475 Irving Ave,Suite 200, Syracuse, NY 13210 USA; [Li, Hsin H.; Morley, Christopher P.; Formica, Margaret K.; Stewart, Telisa M.] SUNY Upstate Med Univ, Dept Publ Hlth & Prevent Med, 766 Irving Ave,Rm 2262, Syracuse, NY 13210 USA; [Morley, Christopher P.] SUNY Upstate Med Univ, Dept Psychiat & Behav Sci, 750 F Adams St, Syracuse, NY 13210 USA; [Lyons, Kathleen D.; Mosher, Terry; Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Geisel Sch Med Dartmouth, Dept Psychiat, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Perrapato, Scott D.; Irwin, Brian H.] Univ Vermont, Coll Med, Dept Surg, Div Urol, Hetcher House 301,111 Colchester Ave, Burlington, VT 05401 USA; [Seigne, John D.; Hyams, Elias S.] Dartmouth Coll, Dartmouth Hitchcock Med Ctr, Geisel Sch Med, Urol Sect, 1 Med Ctr Dr, Lebanon, NH 03756 USA; [Hegel, Mark T.] Dartmouth Hitchcock Med Ctr, Norris Cotton Canc Ctr, Canc Control Program, 1 Med Ctr Dr, Lebanon, NH 03756 USA
Abstract
Background: Active surveillance is a management strategy for men diagnosed with early-stage, low-risk prostate cancer in which their cancer is monitored and treatment is delayed. This study investigated the primary coping mechanisms for men following the active surveillance treatment plan, with a specific focus on how these men interact with their social network as they negotiate the stress and uncertainty of their diagnosis and treatment approach. Methods: Thematic analysis of semi-structured interviews at two academic institutions located in the northeastern US. Participants include 15 men diagnosed with low-risk prostate cancer following active surveillance. Results: The decision to follow active surveillance reflects the desire to avoid potentially life-altering side effects associated with active treatment options. Men on active surveillance cope with their prostate cancer diagnosis by both maintaining a sense of control over their daily lives, as well as relying on the support provided them by their social networks and the medical community. Social networks support men on active surveillance by encouraging lifestyle changes and serving as a resource to discuss and ease cancer-related stress. Conclusions: Support systems for men with low-risk prostate cancer do not always interface directly with the medical community. Spousal and social support play important roles in helping men understand and accept their prostate cancer diagnosis and chosen care plan. It may be beneficial to highlight the role of social support in interventions targeting the psychosocial health of men on active surveillance.
