Mallapareddi Arun, Ruterbusch Julie, Reamer Elyse, Eggly Susan, Xu Jinping
Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA and.
Department of Oncology, Wayne State University, Detroit, MI, USA.
Fam Pract. 2017 Feb;34(1):90-97. doi: 10.1093/fampra/cmw123. Epub 2016 Dec 29.
Active surveillance (AS) is recognized as a reasonable treatment option for low-risk localized prostate cancer (LPC) but continues to be chosen by a minority of men. To date, limited data are available regarding reasons why men with low-risk LPC adopt AS.
The aim of this study is to better understand conceptualizations, experiences and reasons why men with low-risk LPC and their partners adopt AS.
We conducted five focus groups (FGs), three among men with low-risk LPC who had chosen AS and two with their partners. FGs were video/audio recorded, transcribed and analysed using qualitative thematic analysis.
A total of 12 men and 6 partners (all women) participated in FG discussions. The most common reasons for choosing AS were seeing the LPC as 'small' or 'low grade' without need for immediate treatment and trusting their physician's AS recommendation. The most common concerns about AS were perceived unreliability of prostate specific antigen, pain associated with prostate biopsies and potential cancer progression. Partners saw themselves as very involved in their husbands' treatment decision-making process, more than men acknowledged them to be. Multiple terms including 'watchful waiting' were used interchangeably with AS. There appeared to be a lack of understanding that AS is not simply 'doing nothing' but is actually a recognized management option for low-risk LPC.
Emphasizing the low risk of a man's LPC and enhancing physician trust may increase acceptability of AS. Standardizing terminology and presenting AS as a reasonable and recognized management option may also help increase its adoption.
主动监测（AS）被认为是低风险局限性前列腺癌（LPC）的一种合理治疗选择，但仍只有少数男性选择。迄今为止，关于低风险LPC男性采用AS的原因的数据有限。
本研究的目的是更好地理解低风险LPC男性及其伴侣采用AS的概念、经历和原因。
我们进行了五个焦点小组（FGs），其中三个是针对选择AS的低风险LPC男性，另外两个是与他们的伴侣一起进行的。焦点小组进行了视频/音频记录、转录，并使用定性主题分析进行分析。
共有12名男性和6名伴侣（均为女性）参与了焦点小组讨论。选择AS的最常见原因是将LPC视为“小疾病”或“低级别疾病”，无需立即治疗，以及信任医生的AS建议。对AS最常见的担忧是前列腺特异性抗原的不可靠性、前列腺活检相关的疼痛以及潜在的癌症进展。伴侣们认为自己在丈夫的治疗决策过程中参与度很高，高于男性所认可的程度。包括“观察等待（watchful waiting）”在内的多个术语与AS可互换使用。似乎人们缺乏认识到AS并非简单地“什么都不做”，而是低风险LPC的一种公认的管理选择。
强调男性LPC的低风险并增强医生的信任可能会提高AS的可接受性。规范术语并将AS呈现为一种合理且公认的管理选择也可能有助于增加其采用率。
