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Thread: Decision-Making in Prostate Cancer

  1. #1

    Post Decision-Making in Prostate Cancer

    Choosing Active Surveillance Over Other Treatment Options: A Literature Review

    Abstract and Introduction


    A literature review was done using the Cognitive-Social Health Information Processing (C-SHIP) framework to identify how and why men diagnosed with prostate cancer choose active surveillance over other treatment options. Findings indicated men who choose active surveillance have a stronger preference for active or collaborative decision-making than those who choose other treatments. Men primarily choose active surveillance to avoid the side effects of incontinence and erectile dysfunction. This literature review informed the study by Bayliss, Duff, Stricker, and Walker (2016) and found physician recommendation to be the most influential factor when patients make a treatment decision.


  2. #2
    Super Moderator Top User Baz10's Avatar
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    May 2011
    Having now been offered all options twice, I have following extensive discussions with my urologist again decided that the AS route given both my staging and age is the best option(for me that is).
    During discussions on the options my urologist was fairly blunt suggesting that choosing the AS route is primarily the patients decision suggesting that some of us menfolk can live quite contentedly knowing they have PCa, relying on the monitoring frequency and the specialists expertise whilst others "the thought of having PCa is in their minds to much of a risk" and therefore choose a intervention protocol.
    Whilst I am sure for myself I have chosen a route which I am mentally content with for others it may not be "first choice".
    The only time it comes to mind is when the next PSA date comes around and for 5 or 6 days afterwards until the results are in.
    Whilst I agree with the summation it is the specialists advice that influences treatment decisions, the fact remains it is the patients choice.
    Whether my choice proves incorrect only time will tell, do I regret taking the AS route, No I don't .
    Last edited by Baz10; 06-03-2017 at 03:05 PM. Reason: Correction
    Diagnosed stage 3 March 011
    Radical resection April 011
    Restaged 2b April 011.
    12/09 Colonoscopy clear but picked up hospital infection.
    Aorta & femoral arteries occluded.
    Clot buster drugs put me in ICU with internal bleeding. 9 blood units later they got it under control.
    Aortobifemoral surgery 5th May. yughh.
    PET scan indicates clear
    DEXA bone scan clear
    13/5 CT showed "unknown" but no concern from docs.
    Inguinal lymph nodes and severe groin pain.
    Ultrasound and MRI show no nasties. Pheww
    Groin pain and enlarged lymph nodes still there.
    October -still the same pains but under semi control.
    Additional chest CT scan ordered for 11th November prior to surgery.
    Sinus surgery done and dusted.
    July 2014 PSA at 5.10. 2months of antibiotics in case of UTI, jan 2015 PSA at 7.20, 23/08 now 8.2, current 8.1
    Prostate Cancer confirmed Gleason 3+Marginal 4.
    Active surveillance continues.
    PET CT Aug 2017 indicated lung nodule changes
    CT Guided biopsy 7/09
    November 1 Vats Wedge section pathology Glomulated previous infection
    no Cancer.

    Not all's rosy in the garden, but see following.
    Stop grumbling Baz, your still alive and kicking so far.
    Age and illness doesn't define who we are, but more what we are able to do.
    Do what I love doing, when I can until I can't.
    and dodging bullets in the meanwhile, too many bullets at moment.


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