"It's not like I can change my mind later": reversibility and decision timing in prostate cancer treatment decision-making.

Abstract

OBJECTIVE: To explore whether reversibility, decision timing, and uncertainty are relevant to men deciding on treatment for localized prostate cancer (LPC). DESIGN: Secondary qualitative data analysis of unstructured interviews. METHODS: Content analysis of previously collected qualitative data (31 individual interviews, 5 focus groups). We identified the frequency of references to reversibility, decision timing, and uncertainty and related sub-themes. RESULTS: We identified eight themes: reversibility, timing of decision, number of options, "getting it over with," "the way I make decisions," uncertainty among experts, desire for certainty, and probability. Fifteen men mentioned reversibility in individual interviews; 13 mentioned the importance of the timing of their decision. Eleven mentioned the importance of the number of options; twelve "the way I make decisions." Eleven men mentioned the uncertainty of experts, fourteen the desire to "get it over with," and six a desire for certainty. CONCLUSION: This study provides compelling preliminary data suggesting that men consider the reversibility, decision timing, and uncertainty in the prostate cancer treatment decision. PRACTICE IMPLICATION: These findings may be helpful in enhancing support for men facing the treatment decision.