Care Planning for Prostate Cancer Patients on Active Surveillance
Technical Report,15 Sep 2015,14 Sep 2016
The Icahn School of Medicine at Mount Sinai New York United States
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Active surveillance AS is recommended for patients with low-risk prostate cancer to prevent over treatment and maintain sexual and urinary functioning. However, approximately 90 of AS eligible patients opt for curative treatment and 25-50 discontinue AS within 2-5 years without clinical evidence of cancer progression. Research is necessary to examine barriers and facilitators of informed decision-making and adherence to AS. We have conducted focus groups and personal interviews with patients N 33 patients and care providers N 3 to examine barriers and facilitators of AS decisions and adherence. Factors that influence patients decisions to opt for AS include trust in the physicians expertise, good intentions, and skills in detecting cancer progression in a timely manner, and avoidance of sexual and urinary deterioration associated with curative treatment. The partners approval of AS played a significant role in the decision to opt for AS. Patient-provider communication and worries about cancer progression are major determinant factors of patients AS decisions.