Medical, personal factors affect continuation of active surveillance in men

Men take into consideration both personal and medical factors when deciding to continue active surveillance (AS), reports a recent study.

The study included 103 men who were given a questionnaire to assess their reasons for continuing/discontinuing AS and receiving definitive treatment. All patients had to be on AS for at least 6 months before they were eligible for enrolment. A subset of 33 participants were further interviewed to qualify their questionnaire responses.

Of the participants, more than half (51 percent; n=53) discontinued AS and moved on to definitive treatment, while 47 percent remained on AS. While both medical and personal reasons factored into their decision to terminate AS, these did so to differing degrees.

For instance, half of patients who progressed to treatment indicated, through a visual analogue scale, that their reasons for doing so were either balanced between medical and personal, or skewed slightly to personal reasons. A third, on the other hand, responded that their reasons were mostly medical in nature.

Meanwhile, among those who were still on AS, their desire to seek definitive treatment in the future were due to a balanced mix of personal and medical reasons.

Qualitative interviews confirmed these findings and revealed that while most men were primarily motivated to seek definitive treatment by medical reasons, their decisions were ultimately supported by or in consideration of personal matters.

Interview responses produced three major themes: Fear, worry, and uncertainty; a desire to act now; and disease progression indicates a need for action. These were the major driving reasons behind the decision to terminate AS and start treatment.