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How do prostate cancer patients navigate the active surveillance journey? A 3-year longitudinal study

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Objective

To investigate whether prostate cancer (PCa) patients’ coping strategies (i.e., fighting spirit, anxious preoccupation, fatalism, helplessness/hopelessness, and avoidance) significantly change during the first 3-year follow-up period of active surveillance (AS).

Materials and methods

Altogether, 104 patients on AS completed the Mini-Mental Adjustment to Cancer (Mini-MAC) at baseline (T0), at 10 and 12 months after diagnostic biopsy (T1 and T2, respectively) and then at 24- (T3) and 36-month (T4) follow-up. Paired samples T test was used to detect statistically significant changes over time. Changes ≥ 1 point (or ≤ − 1) were hypothesized to be clinically relevant.

Results

During the first 3 years on AS, men experienced decreased anxiety, avoidance thoughts/behaviors, and fight-against-cancer attitudes, and these changes were found to be statistically significant. When considering clinically significant changes between inclusion in AS (T0) and 3-year follow-up (T4), avoidance decreased in 19% of patients.

Conclusions

Most patients were observed to have adopted functional coping strategies at baseline, which were maintained through the first 3 years on AS. Overall, men on AS may perceive increasing control over their cancer and comfort with the AS protocol over time and experience slight decreases in anxious preoccupation, cancer-related avoidance thoughts and behaviors, and fight-against-cancer reactions. For those men who find it difficult to cope with AS, psychological monitoring and interventions could be helpful throughout the monitoring journey.

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Acknowledgments

The authors thank Fondazione Italo Monzino for support for the project “Per un sentire condiviso: l’uomo e il tumore alla prostrate.”

Funding

The study was financially supported by the Associazione Italiana Ricerca sul Cancro (AIRC IG16087).

Author information

Authors and Affiliations

  1. Fondazione IRCCS Istituto Nazionale dei Tumori, Prostate Cancer Program, Milan, Italy

    Paola Dordoni, Fabio Badenchini, Maria Francesca Alvisi, Letizia De Luca, Teresa Di Florio, Tiziana Magnani, Cristina Marenghi, Tiziana Rancati, Riccardo Valdagni & Lara Bellardita

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Julia Menichetti

  3. Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy

    Riccardo Valdagni

  4. Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Riccardo Valdagni

Authors
  1. Paola Dordoni
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  2. Fabio Badenchini
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  3. Maria Francesca Alvisi
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  4. Julia Menichetti
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  5. Letizia De Luca
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  6. Teresa Di Florio
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  7. Tiziana Magnani
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  8. Cristina Marenghi
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  9. Tiziana Rancati
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  10. Riccardo Valdagni
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  11. Lara Bellardita
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Correspondence to Paola Dordoni.

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Dordoni, P., Badenchini, F., Alvisi, M.F. et al. How do prostate cancer patients navigate the active surveillance journey? A 3-year longitudinal study. Support Care Cancer 29, 645–651 (2021). https://doi.org/10.1007/s00520-020-05524-8

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  • DOI: https://doi.org/10.1007/s00520-020-05524-8

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