Optimizing psychosocial support in prostate cancer patients during active surveillance

What are the psychosocial support needs of prostate cancer (PCa) patients undergoingactive surveillance (AS)? The preferred management strategy for low-risk PCa (LR-PCa) isAS. Patients remain under close surveillance to monitor disease progression. However,living with untreated disease has psychosocial implications. The objective of this studywas to investigate the psychosocial support needs in PCa patients undergoing AS.According to Marzouk (2018) 30% of patients risk developing anxiety during the firstyear of AS. Parker (2015) and Tan (2016) suggest approximately 10% of AS-patientsrequest a change to active treatment, often based on anxiety. Pickles (2007) states thatpsychosocial support can effectively reduce anxiety and uncertainty. A literature basedinterview guide was used to conduct 17 semi-structured interviews following an explor-ative qualitative approach. LR-PCa patients, eligible for AS, were enrolled from two par-ticipating Dutch urology clinics experiencedwithAS.Writteninformedconsentwasobtained. Inclusion ended after attaining data saturation. The interviews were transcribedverbatim. NVIVO 10 was used for open coding. Participants expressed recurring uncer-tainty and anxiety caused by medical examinations, lower urinary tract symptoms anderectile dysfunction. Various effective and ineffective coping strategies were adopted byparticipants. The use of specific strategies was associated with patient-physician relation-ship, locus-of-control and disease-acceptation. Ineffective coping strategies seemed toimpede resilience during stressful situations. Satisfactory decision-making and disease-acceptation were promoted by immediate availability of relevant, reliable informationregarding disease characteristics and treatment options. Early-stage reliable and rele-vant information, assessment and encouragement of effective coping strategies appearto be important psychosocial support needs during AS. Most participants in this studyhad spousal support and completed higher education. Future research should deter-mine the generalizability of these findings in a more heterogeneous population.