Prostate cancer treatment decisions: a focus group exploration

To explore the decision-making process as retrospectively described by patients with prostate cancer and their spouses and to test the feasibility of a larger scale prospective examination of decision making in this same population.

A qualitative study using focus group methodology.

Twelve patients with prostate cancer and six spouses were recruited purposefully from a newly organized prostate cancer support group in an urban North Carolina community.

Using an interview guide, an experienced facilitator conducted two 90-minute focus groups. Sessions were audiotaped, transcribed verbatim, and analyzed using thematic content analysis techniques.

Decision making, prostate cancer treatment, spousal participation.

Six themes were derived from the data: (a) Finding Out, (b) Prostate Specific Antigen Talk, (c) (Getting the Story, (d) Who Decides, (e) Treatment Options, and (f) Looking Back. The data corroborated American Cancer Society findings that national cancer resources are not being used effectively by this population and reinforced the need for a multidisciplinary approach to the management of prostate cancer.

Additional prospective studies are needed to explore the decision process from a family perspective. Studies focusing on the unique needs of older patients with prostate cancer and their spouses also are needed.

Nurses must assess informal information sources and work toward a more comprehensive presentation of treatment options. Misconceptions about surgery and radiotherapy hamper informed decision making. Nurses are in a unique position to educate families regarding prostate cancer treatment options.