Is 'watchful waiting' a real choice for men with prostate cancer? A qualitative study
- PMID: 12133062
- DOI: 10.1046/j.1464-410x.2002.02846.x
Is 'watchful waiting' a real choice for men with prostate cancer? A qualitative study
Abstract
Objective: To understand what leads men to choose 'watchful waiting' rather than active treatment for cancer of the prostate.
Patients and methods: Fifty men with confirmed prostate cancer in England, Wales and Scotland were interviewed about all aspects of their illness, for a Database of Individual Patients' Experience of illness. The sample included men at different stages of diagnosis and with experience of a wide range of treatments. We report here only what men said about their choice of treatment and the decision-making process.
Results: Watchful waiting would have been clinically inappropriate for almost half of the men (those with serious urinary symptoms and those with metastatic disease). However, few of the men who might have chosen watchful-waiting remembered this being presented as a serious option. Most in this group chose radical prostatectomy, radiotherapy, brachytherapy or cryosurgery. The few who chose watchful waiting had found doctors who supported their decision, had assessed the evidence from Internet sites, and were concerned about the side-effects and uncertain outcome of treatment. Men who chose watchful waiting, as well as those who opted for treatment, described considerable pressure from family members, doctors or support groups, to seek active treatment.
Conclusion: This study helps to explain why some men will not contemplate watchful waiting, and why others may find it difficult to pursue that option. Understanding men's concerns may help clinicians to support men's treatment decisions. Treatment for prostate cancer is highly controversial because no randomized, controlled trials have shown whether or not active intervention increases survival. If trials are not completed it cannot be determined whether active treatments are the best course of action for men with prostate cancer.
Similar articles
-
'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.Psychooncology. 2014 Dec;23(12):1391-8. doi: 10.1002/pon.3576. Epub 2014 May 16. Psychooncology. 2014. PMID: 24830805
-
Management of localised prostate cancer: watchful waiting, surgery or radiation therapy, depending on the natural course, which is often relatively slow.Prescrire Int. 2012 Oct;21(131):242-8. Prescrire Int. 2012. PMID: 23185849 Review.
-
Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial.Lancet Oncol. 2011 Sep;12(9):891-9. doi: 10.1016/S1470-2045(11)70162-0. Epub 2011 Aug 5. Lancet Oncol. 2011. PMID: 21821474 Clinical Trial.
-
Prospective study of men's psychological and decision-related adjustment after treatment for localized prostate cancer.Urology. 2004 Apr;63(4):751-6. doi: 10.1016/j.urology.2003.11.017. Urology. 2004. PMID: 15072894
-
The watchful waiting management option for older men with prostate cancer: state of the science.Oncol Nurs Forum. 2004 Nov 16;31(6):1057-66. doi: 10.1188/04.ONF.1057-1066. Oncol Nurs Forum. 2004. PMID: 15547629 Review.
Cited by
-
How do cancer patients refuse treatment? A grounded theory study.BMC Palliat Care. 2023 Feb 7;22(1):10. doi: 10.1186/s12904-023-01132-5. BMC Palliat Care. 2023. PMID: 36750817 Free PMC article.
-
Factors Influencing Men's Choice of and Adherence to Active Surveillance for Low-risk Prostate Cancer: A Mixed-method Systematic Review.Eur Urol. 2018 Sep;74(3):261-280. doi: 10.1016/j.eururo.2018.02.026. Epub 2018 Mar 26. Eur Urol. 2018. PMID: 29598981 Free PMC article.
-
Demographic Disparities and Factors Influencing Cancer Treatment Decision-Making.J Cancer Educ. 2025 Feb 3. doi: 10.1007/s13187-025-02570-w. Online ahead of print. J Cancer Educ. 2025. PMID: 39894898
-
Qualitative studies on men with prostate cancer: a systematic meta-synthesis.Int J Qual Stud Health Well-being. 2025 Dec;20(1):2436720. doi: 10.1080/17482631.2024.2436720. Epub 2024 Dec 24. Int J Qual Stud Health Well-being. 2025. PMID: 39719863 Free PMC article.
-
Helping patients with localized prostate cancer reach treatment decisions.Can Fam Physician. 2010 Feb;56(2):137-41. Can Fam Physician. 2010. PMID: 20154243 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical