An exploration of the impact of treatment decision making on men diagnosed with localised prostate cancer in an island setting

The focus of this dissertation is a phenomenological study of the experiences of men diagnosed with localised prostate cancer, their treatment decision and the impact this has had on their lives. The setting is an off shore Island with the need to travel to the mainland for treatment. Prostate cancer is a significant health burden with approximately 1 in 8 men likely to receive this diagnosis. The introduction of the Prostate Specific Antigen (PSA) blood test has meant that prostate cancer is detected earlier and curative treatment available. However, there is no gold standard treatment for localised prostate cancer and men are required to make or be involved in the decision-making process.The impact of the Covid-19 pandemic meant that the initial proposed methods had to be revisited during the course of the research. A purposive sample of 5 participants completed a questionnaire comprised of open questions that aimed to gain an insight into the thoughts and feelings of the participants along their cancer trajectory with particular focus on the decision-making process and how this impacted on their lives. The data collected from the interview questionnaire transcripts was analysed using Colaizz’s framework. Six themes were formulated from the 30 cluster themes that emerged. The participants described the many emotions they experienced and each one described shock at diagnosis. The need for individualised information and communication was emphasised. A commonality was the importance of assessing how involved they wanted to be in decision-making. The influences on their treatment decision varied considerably. However the most influential was doctor recommendation/suggestion. Each participant described sufficient support and no treatment regret.The findings of this study have provided an insight into the experience of men receiving a diagnosis of prostate cancer and the impact the treatment decision- making process on their lives. The importance of an individual need’s assessment and additional clinical nurse specialist involvement are recommended to improve current practice.