Men's perception of fatigue when newly diagnosed with localized prostate cancer

Cancer is a complicated issue both medically and psychosocially, and the process of the disease affects the whole human being. Fatigue is the commonest symptom associated with cancer and its treatment. Prostate cancer is the third commonest male cancer worldwide and the leading cause of male cancer death. The aims of this study were: (i) to identify whether fatigue is found in men with newly diagnosed localized prostate cancer (predominantly early-stage, very low tumour burden asymptomatic patients); and (ii) to gain a perception of whether fatigue has an influence on these men and to try to find out what the cause of this fatigue was.

Sixteen men who had been newly diagnosed with localized prostate cancer were interviewed to determine whether fatigue is experienced by such men and whether it has an effect on them. Verbal transcripts were analyzed using hermeneutical interpretation.

Five equivalent fusions were identified according to the time when the participants received their diagnosis of early-stage prostate cancer. These fusions occurred successively, in three steps. The first step was Enclosing Intrapersonal Emotions and Enclosing Interpersonal Attachments, when the men were living in a kind of vacuum. Moving onto step two, another two fusions were triggered and contributed to a positive attitude: Reopening Intrapersonal Emotions and Reopening Interpersonal Attachments. Finally, at step three, a unifying fusion was identified: Living with a New Perspective. This study provides insights and new knowledge indicating that prostate cancer does not in itself cause fatigue.

The clinical implications of these findings are that it is not possible to handle new and detailed information about prostate cancer at the first visit. The need for information occurs, however, relatively soon afterwards and it would seem appropriate to offer a new appointment within 1 week of the first visit.