Abstract
Several life-prolonging treatment options have recently become available for metastatic castration-resistant prostate cancer. However, research regarding patient experiences while undergoing these treatments is scarce. The aim was to explore the perspectives of men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. Qualitative interviews were conducted with 16 men as they were starting, undergoing or had completed their first life-prolonging treatment. Interpretive description was used for analysis. The results illuminate the complexity of facing life-prolonging treatment, with interlaced dimensions beyond just the outcome, and where the men described other dimensions of their lives in relation to the treatment. The results are presented as 4 themes; Considering treatment when the remainder of life is at stake, Preparing for the life-prolonging treatment after deciding to go through with it, Considering the prospect of the life-prolonging treatment not being successful and Reflecting on death and dying in the light of a life-limiting illness. The quality and content of the remainder of life are central for men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. This is important when weighing desired treatment outcomes against side effects, and when reflecting upon whether going through with treatment would be worth it or not. The results illuminate the importance of encouraging men at this stage to express expectations, hopes and fears regarding the treatment and the future when considering life-prolonging treatments. Nurses working with these patients are important in the decision-making process and in evaluating treatments, to detect needs for interventions.
Highlights
Prostate cancer (PC) has a high global incidence (Siegel et al, 2018; Ferlay et al, 2013)
Patient-reported outcome measures have been shown to be important for evaluating quality of life (QoL) and function in men with metastatic castration-resistant prostate cancer (mCRPC) (Eton et al, 2010)
Research on patient expectations on chemotherapy treatment of other advanced cancers suggest that a substantial number of patients may not have understood that the chemotherapy would not cure their cancer (Weeks et al, 2012; Nowicki et al, 2015)
Summary
Prostate cancer (PC) has a high global incidence (Siegel et al, 2018; Ferlay et al, 2013). The most advanced, incurable stage of the disease, metastatic castration-resistant prostate cancer (mCRPC), is defined by a resistance to castration treat ment (Cornford et al, 2017). In this palliative phase, health-related quality of life (HRQoL) is rapidly deteriorating and the symptom burden is often severe (Burbridge et al, 2020), even for patients receiving disease-directed treatments (Sullivan et al, 2007; Lindqvist et al, 2008a). Treatment expectations have not been studied in men undergoing life-prolonging treatment of mCRPC. Research on patient expectations on chemotherapy treatment of other advanced cancers suggest that a substantial number of patients may not have understood that the chemotherapy would not cure their cancer (Weeks et al, 2012; Nowicki et al, 2015)
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