References
The psychological impact of active surveillance in men with prostate cancer: implications for nursing care
Abstract
Introduction:
Active surveillance is a conservative management approach to treating prostate cancer involving regular testing and close monitoring by the health professional. The aim of this literature review is to establish whether men experience a psychological impact of active surveillance and what the prevalent effects might be.
Method:
The search was carried out in three databases: CINAHL, Medline and PsycINFO. Articles published in English, from October 2015 to March 2018, which focused on the psychological impact of active surveillance, were included.
Findings:
A total of eight quantitative studies were included in this report. The review identified key psychological impacts of active surveillance, including anxiety, sub-clinical depression, illness uncertainty and hopelessness. Active surveillance was seen by some patients as a positive treatment approach that limited the side effects associated with active treatment.
Conclusion:
The evidence found a negative impact of active surveillance might be felt by men at any stage during treatment and at differing levels of severity. The article highlights key demographic areas, including ethnicity and age, for future research and recommends more qualitative studies are conducted.
Prostate cancer is the second most common cancer in men worldwide, affecting one in eight men in the UK (World Cancer Research Fund, 2018; Prostate Cancer UK, 2019a). In the UK, prostate cancer was the most common cancer diagnosed in males in 2017, a total of 41 201 cases were registered—accounting for one in four malignant cancer recordings (Office for National Statistics, 2019).
Although there is no screening programme for prostate cancer in the UK, there is an informed choice programme in place for healthy men aged 50 and older who wish to ask their GP about prostate-specific antigen score (PSA) testing. It is possible to detect non-progressive cancers through screening, leading to over diagnosis and over-treatment (Bell et al, 2015). Although most men diagnosed with prostate cancer will die with, rather than of, the disease, an increase in PSA screening has meant an increase in cancer diagnoses and use of invasive treatment to remove it (Bell and Kazanjian, 2011).
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