Lyons Kathleen D, Li Hsin H, Mader Emily M, Stewart Telisa M, Morley Christopher P, Formica Margaret K, Perrapato Scott D, Seigne John D, Hyams Elias S, Irwin Brian H, Mosher Terry, Hegel Mark T
1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
2 SUNY Upstate Medical University, Syracuse, NY, USA.
Am J Mens Health. 2017 Jan;11(1):63-72. doi: 10.1177/1557988316657041. Epub 2016 Jul 7.
Benefits of early diagnosis and treatment remain debatable for men with low-risk prostate cancer. Active surveillance (AS) is an alternative to treatment. The goal of AS is to identify patients whose cancer is progressing rapidly while avoiding treatment in the majority of patients. The purpose of this study was to explore cognitive and affective representations of AS within a clinical environment that promotes AS a viable option for men with low-risk prostate cancer. Participants included patients for whom AS and active treatment were equally viable options, as well as practitioners who were involved in consultations for prostate cancer. Data were generated from semistructured interviews and audits of consultation notes and were analyzed using thematic analysis. Nineteen patients and 16 practitioners completed a semistructured interview. Patients generally viewed AS as a temporary strategy that was largely equated with inaction. There was variation in the degree to which inaction was viewed as warranted or favorable. Patient perceptions of AS were generally malleable and able to be influenced by information from trusted sources. Encouraging slow deliberation and multiple consultations may facilitate greater understanding and acceptance of AS as a viable treatment option for low-risk prostate cancer.
对于低风险前列腺癌男性患者而言，早期诊断和治疗的益处仍存在争议。主动监测（AS）是一种治疗替代方案。主动监测的目标是识别那些癌症进展迅速的患者，同时避免对大多数患者进行治疗。本研究的目的是在一个将主动监测作为低风险前列腺癌男性可行选择加以推广的临床环境中，探索主动监测的认知和情感表征。参与者包括那些主动监测和积极治疗都是同样可行选择的患者，以及参与前列腺癌会诊的从业者。数据来自半结构化访谈和会诊记录审核，并采用主题分析法进行分析。19名患者和16名从业者完成了半结构化访谈。患者通常将主动监测视为一种临时策略，在很大程度上等同于不作为。对于不作为在何种程度上被视为合理或有利，存在差异。患者对主动监测的认知通常具有可塑性，并且能够受到来自可靠来源信息的影响。鼓励缓慢决策和多次会诊可能有助于更好地理解和接受主动监测作为低风险前列腺癌的一种可行治疗选择。
