'What is this active surveillance thing?' Men's and partners' reactions to treatment decision making for prostate cancer when active surveillance is the recommended treatment option.

OBJECTIVE: In the past decade, localised prostate cancer (LPC) management has been shifting from three radical treatment options (radical prostatectomy, external beam radiotherapy, or brachytherapy) to also include active surveillance (AS). This study examines men with LPC and partners' experiences of choosing between AS and radical treatments, and their experiences of AS when selected. METHODS: A qualitative descriptive research design was used. Interviewed participants were men, and partners of men, who either had chosen radical treatment immediately following diagnosis or had been on AS for at least 3 months. AS was the recommended treatment. Transcribed interviews were thematically analysed and inter-rater reliability integrated. RESULTS: Twenty-one men and 14 partners participated. Treatment decisions reflected varied reactions to prostate cancer information, regularly described as contradictory, confusing, and stressful. Men and partners commonly misunderstood AS but could describe monitoring procedures. Partners often held the perception that they were also on AS. Men and partners usually coped with AS but were sometimes encumbered by treatment decision-making memories, painful biopsies, ongoing conflicting information, and unanswered medical questions. Radical treatment was selected when cancer progression was feared or medically indicated. Some preferred doctors to select treatments. CONCLUSIONS: To reduce distress frequently experienced by men diagnosed with LPC and their partners during treatment decision making and ongoing AS monitoring, the following are needed: improved community and medical awareness of AS; consistent information about when radical treatment is required; and consistent, unbiased information on treatment options, prognostic indicators, and side effects. Regularly updated decisional support information/aids incorporating men's values are imperative.

Satisfaction with nurse-led telephone follow up for low to intermediate risk prostate cancer patients treated with radical radiotherapy. A comparative study.

PURPOSE OF THE RESEARCH: As the number of men living with prostate cancer is increasing worldwide, the requirement for follow up care also grows. This study was undertaken to evaluate nurse-led, telephone follow up, for men with low to intermediate risk prostate cancer treated with radical radiotherapy when compared with medical follow up. METHODS AND SAMPLE: A non-randomized, two-cohort, comparative study. 169 men diagnosed with prostate cancer were recruited from outpatient clinics at a tertiary cancer centre in Australia. 83 men were recruited to cohort 1 (control) (51 low to intermediate risk; 32 high risk) and 86 to cohort 2 (intervention) (51 low to intermediate risk; 35 high risk). High risk patients, regardless of cohort, received medical follow up. Low to intermediate risk patients in cohort 2 were triaged to nurse-led review for their six month review appointment. Nurse-led follow up consisted of six monthly telephone consultations and PSA testing. MEASURES: Participants completed the Satisfaction with Consultation Scale, the Brief Distress Thermometer and the Expanded Prostate Cancer Index Composite. KEY RESULTS: There was no statistically significant difference in patient satisfaction on any of the study measures between the nurse-led and standard medical follow up at six months following treatment completion. However, where there was a trend towards significance (p=0.051), it favoured the nurse-led follow up regimen. CONCLUSIONS: Nurse-led telephone consultation provides an acceptable model of follow-up for men diagnosed with low to intermediate risk prostate cancer. Multi-centre randomised controlled trials are needed to support the efficacy of nurse-led, telephone follow up services.

Patient expectations and preferences for follow-up after treatment for lung cancer: a pilot study.

INTRODUCTION: There is no robust evidence to indicate the most appropriate models of follow-up care for patients who have completed treatment for lung cancer. This pilot study aimed to assess expectations and preferences for follow-up care in a sample of patients who had completed treatment for lung cancer. METHOD: Thirty-one patients who had completed treatment for primary lung cancer were recruited. A 13 item self-report survey was developed to elicit patient's preferences and expectations for follow-up. Participants completed the developed survey and clinical and demographic variables were collected. RESULTS: Factors scored as extremely important by over 80% of respondents focused on care coordination: Being able to see the same doctor or health care professional at each visit (24/83%); Knowing which doctor or nurse to contact if queries arise between follow-up appointments (23/82%); and Knowing the patient can book an appointment or contact a health care professional involved in their care regarding health concerns between visits (25/89%). Patients were supportive of nurse-led follow-up when offered in the context of a model of shared care (21/78%). CONCLUSION: This study offers new insight into the expectations and preferences for follow-up of patients with lung cancer, with participants indicated preference for intensive follow-up after the completion of treatment.