Patient acceptance of active surveillance as a treatment option for low-risk prostate cancer

OBJECTIVES To examine the decision-making processes of men on active surveillance (AS). To identify the resources that men want to access to make, support and sustain them while on AS. PATIENTS AND METHODS Three-part survey developed for this study based on a qualitative study of 25 men on AS. Survey items explored: role men assumed with their physician in treatment decision-making, factors influencing decision to go on AS, and resources required while on AS. Surveys mailed out to cross-sectional sample of men on AS for less than 10 years. RESULTS 27% of the 73 men reported assuming an active role in treatment decision-making with their urologist, 41% a shared role and 32% a passive role. 82% of men reported being comfortable and 90% being satisfied with their decision to be on AS. 55% reported not being anxious about the cancer progressing while on AS. Urologist's opinion, current age, and impact of treatment on urinary function were main factors influencing treatment decision. Information on future treatment options, non-traditional treatments and diet considered most important resources. CONCLUSIONS Results suggest that once men make a decision to go on AS, they are satisfied with their decision and few report being anxious about progression of cancer. Men are strongly influenced by the treating specialist in taking up AS. Additional information and psychological support resources are required for men on AS.