Canadian Men’s perspectives about active surveillance in prostate cancer: need for guidance and resources

Margaret Fitch, Kittie Pang, Veronique Ouellet, Carmen Loiselle, Shabbir Alibhai, Simone Chevalier, Darrel E. Drachenberg, Antonio Finelli, Jean-Baptiste Lattouf, Simon Sutcliffe, Alan So, Simon Tanguay, Fred Saad, Anne-Marie Mes-Masson

In prostate cancer, men diagnosed with low risk disease may be monitored through an active surveillance. This research explored the perspectives of men with prostate cancer regarding their decision-making process for active surveillance to identify factors that influence their decision and assist health professionals in having conversations about this option. Focus group interviews (n = 7) were held in several Canadian cities with men (N = 52) diagnosed with prostate cancer and eligible for active surveillance. The men's viewpoints were captured regarding their understanding of active surveillance, the factors that influenced their decision, and their experience with the approach. A content and theme analysis was performed on the verbatim transcripts from the sessions. Patients described their concerns of living with their disease without intervention, but were reassured by the close monitoring under AS while avoiding harmful side effects associated with treatments. Conversations with their doctor and how AS was described were cited as key influences in their decision, in addition to availability of information on treatment options, distrust in the health system, personality, experiences and opinions of others, and personal perspectives on quality of life. Men require a thorough explanation on AS as a safe and valid option, as well as guidance towards supportive resources in their decision-making.