How Does Active Surveillance for Prostate Cancer Affect Quality of Life?:A Systematic Review

The optimal management of screen-detected, localised prostate cancer remains controversial, related to overtreatment issues of screening and the nonrandomised evidence base. Active surveillance (AS) aims to delay or avoid curative therapy but may potentially harm patients' well-being through living with untreated prostate cancer

Multidisciplinary Versus One-on-One Setting: A Qualitative Study of Clinicians' Perceptions of Their Relationship With Patients With Prostate Cancer

The authors' evaluation of the pros and cons of the multidisciplinary approach indicates that the dynamism inherent in multidisciplinary care represents a challenge, which may explain why clinicians appear to prefer communication in a one-on-one setting

Treatment decision-making process of men with newly diagnosed localized PCa: the role of multidisciplinary approach in patient engagement

The diagnosis of prostate cancer (PCa) often represents a stressful event. In addition to the psychological distress related to the diagnosis, patients face challenging health decisions: in fact, besides radical  treatments, Active Surveillance may represent an option for patients with diagnosis of localized PCa. A multidisciplinary clinical approach seems to represent the suitable organizational model to meet such a requirement, optimising the therapeutic outcome for PCa patients.The present study is a qualitative examination of the treatment decision-making process of men with a newly diagnosed localized PCa who received a multidisciplinary clinical consultation. Results suggest that a multidisciplinary approach may satisfy patients’ need to be comprehensively informed about all their chances and options of curing and managing the disease. Together with information, patients need to build a therapeutic relationship with the physicians in order to share their treatment decision-making experience. If this does not occur, frustration, confusion and other negative emotions may emerge

Ipnosi e dolore

Ipnosi e dolor

Cross-cultural differences in men on active surveillance’ anxiety: a longitudinal comparison between Italian and Dutch patients from the Prostate cancer Research International Active Surveillance study

Background: Men diagnosed with localized prostate cancer (PCa) on active surveillance (AS) have shown to cope with anxiety caused by living with an ‘untreated cancer’ and different factors can influence the tolerance level for anxiety in these patients. The present study analyzes Italian (Milan) and Dutch (Rotterdam) men prospectively included in the Prostate cancer International Active Surveillance (PRIAS) trial, aiming to explore whether socio-demographic factors (i.e. age, relationship status, education, nationality) may be relevant factors in conditioning the level of anxiety at AS entry and over time. Methods: Italian and Dutch men participating in the IRB-approved PRIAS study, after signing an informed consent, filled in the Memorial Anxiety Scale for PCa (MAX-PC) at multiple time points after diagnosis. A linear mixed model was used to assess the relationship between the level of patient’s anxiety and time spent on AS, country of origin, the interaction between country and time on AS, patients’ relationship status and education, on PCa anxiety during AS. Results: 823 MAX-PC questionnaires were available for Italian and 307 for Dutch men, respectively. Median age at diagnosis was 64 years (IQR 60–70 years) and did not differ between countries. On average, Dutch men had a higher total MAX-PC score than Italian men. However, the level of their anxiety decreased over time. Dutch men on average had a higher score on the PCa anxiety sub-domain, which did not decrease over time. Minimal differences were observed in the sub-domains PSA anxiety and fear of recurrence. Conclusion: Significant differences in PCa anxiety between the Italian and Dutch cohorts were observed, the latter group of men showing higher overall levels of anxiety. These differences were not related to the socio-demographic factors we studied. Although both PRIAS-centers are dedicated AS-centers, differences in PCa-care organization (e.g. having a multidisciplinary team) may have contributed to the observed different level of anxiety at the start and during AS. Trial registration This study is registered in the Dutch Trial Registry (www.trialregister.nl) under NL1622 (registration date 11-03-2009), ‘PRIAS: Prostate cancer Research International: Active Surveillance—guideline and study for the expectant management of localized prostate cancer with curative intent’