Hormone Ablation for the Treatment of Prostate Cancer: The Lived Experience
Computing, Health and Science
School of Nursing, Midwifery and Postgrad Medicine, WA Centre for Cancer and Palliative Care
Introduction: Prostate cancer is the most common cancer among males in the United States as well as in Australia. Hormone therapy may be used to treat men at different stages of prostate cancer. The goal of treatment may vary from neo-adjuvant, adjuvant, to palliative. To date, no studies have examined men’s perceptions of hormone treatment during different treatment stages. Purpose: The purpose of this study was to provide an understanding of the experience of men living with prostate cancer and the ways in which hormone ablation therapy affects those experiences. Method: A phenomenologic approach guided this study. Twenty men (ages 50-70) diagnosed with prostate cancer participated in in-depth interviews. Participants were selected after having undergone one of the following treatments: hormone therapy 4 to 6 months prior to radioactive seed implantation; hormone therapy prior to treatment with external beam radiotherapy; hormone therapy 12 months post-radical prostatectomy; or hormone ablation therapy for palliation of metastatic prostate cancer. Data included audiotaped interviews and observational field notes. Data were analyzed using QSR International NUDI*ST software (Nonnumerical Unstructured Data by Indexing, Searching and Theorising, Version 6.21) and following steps outlined by Streubert and Carpenter (1995). These included explicating a personal description of the phenomenon of interest, bracketing the researcher’s presuppositions, interviewing participants, carefully reading over the transcript to uncover essences, apprehending essential relationships, developing formalized descriptions of phenomenon, returning to participants to validate descriptions, reviewing relevant literature, and distributing findings to the nursing community. Content analysis was accomplished by following an adaptation of Huberman and Miles’ (1994) tactics for generating meaning of textual data. Findings: An illness trajectory, comprised of five phases, was identified: Discovering the Disease, Decision- Making Dilemma, Experiencing the Effects of Treatment, Living with Outcomes and Reaching Toward Health. Responses of men to these phases of illness were described in relation to each of the illness phases. Men also described Coping Strategies they used in an effort to manage the illness phases and their responses to these phases. A final theme was identified, Quality of Health Care Relationships. Descriptions of this theme revealed that the Quality of Health Care Relationships underpinned men’s responses to the illness phases and influenced their abilities to develop helpful Coping Strategies. Conclusions This study provides further insight into the experiences of living with, and being treated for, prostate cancer. Interventions or support strategies should focus on the dilemma men face in deciding on a choice of treatment, coping with potential side effects, and developing a positive outlook for the future. Inclusion of partners or family support is essential to ensure that men undergoing hormone therapy for the treatment of prostate cancer are better prepared to cope with the uncertainty of illness and challenges of treatment.