Patient Perspectives of the Implementation of a Prostate Cancer Survivorship Clinic: A Pilot Qualitative Analysis

Abstract

ABSTRACT Introduction With almost 17 million prostate cancer survivors in the United States, survivorship is becoming a significant phase of the disease state. While research on prostate cancer survivorship is expanding, a qualitative understanding of life with and after prostate cancer remains understudied. Due to the long horizon-time of prostate cancer complications and treatment side effects, a clear understanding of the patient experience, and the perceived value of survivorship care, is essential to implementing a successful patient-centered survivorship program. Objective To explore the patient-perceived role and value of a newly created prostate cancer survivorship clinic with the goal of implementing feedback to improve the survivorship clinic experience and maximizing its benefit. Methods Demographic data were collected on prostate cancer patients who underwent a robotic-assisted laparoscopic prostatectomy (RALP) during a 6-month period from September 2020 through February 2021. Phone interviews were conducted by a single researcher on a sample of eleven survivorship clinic patients. Conversations were recorded and inductive thematic analysis was used to identify patient perceptions, values and goals regarding the survivorship experience. The survivorship clinic was established as a part of our institution's cancer center and is staffed by an experienced oncology nurse practitioner, trained in both prostate cancer-specific care and survivorship care in general. Results Of the 174 men who underwent a RALP from September 2020 through February 2021, 118 (67.8%) were enrolled in the Prostate Cancer Survivorship Clinic. Ninety-eight of 118 (83.1%) patients attended at least 1 clinic appointment and 20 (16.9%) attended 2 appointments at the time of our implementation analysis. Median age of interviewed patients was 62 years (IQR 57-67.5). Median time from RALP to the most recent survivorship clinic appointment for interviewed patients was 42 days (IQR 42-43.5). Three primary themes were identified through this analysis: the value of the survivorship clinic in personalizing prostate cancer follow-up, the role of the survivorship clinic as a conveyer of information, and the focus of patients on sexual function as a marker of normalcy in survivorship. A majority of men referred to their survivorship clinic provider and the survivorship program interchangeably and cited the relationship with their provider as a key value of the survivorship clinic experience. Men viewed the role of the clinic to be a source of personalized information about prostate cancer and the recovery process and felt that survivorship clinic appointments were the appropriate place to ask follow-up questions that they perceived as “time-wasting” in their surgery appointments. Patients overwhelmingly identified sexual functional recovery as a priority in the survivorship process and often remarked on it as a surrogate marker of overall recovery. Conclusions Prostate cancer survivorship programs are essential given the life expectancy of men following prostate cancer treatment. Patient needs and survivorship goals should drive expansion and improvement of survivorship programs and focus on personal relationship building, targeting and personalization of information dissemination and sexual functional recovery. This pilot justifies an expanded qualitative analysis to better characterize the patient-perceived value of survivorship clinics. Disclosure No