‘It Just Makes Sense to Me’: A qualitative study exploring patient decision‐making and experiences with prostate MRI during active surveillance for prostate cancer

Author:

Sutherland Ryan1ORCID,Gross Cary P.234,Ma Xiaomei23,Jeong Farah5,Seibert Tyler M.678,Cooperberg Matthew R.910,Catalona William J.11,Ellis Shellie D.12,Loeb Stacy1314,Schulman‐Green Dena15,Leapman Michael S.2316ORCID

Affiliation:

1. Yale School of Medicine New Haven Connecticut USA

2. Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut USA

3. Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USA

4. Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA

5. Yale School of Public Health New Haven Connecticut USA

6. Department of Radiation Medicine and Applied Sciences University of California San Diego La Jolla California USA

7. Department of Radiology University of California San Diego La Jolla California USA

8. Department of Bioengineering University of California San Diego La Jolla California USA

9. Department of Urology University of California San Francisco San Francisco California USA

10. Department of Epidemiology and Biostatistics University of California San Francisco San Francisco California USA

11. Department of Urology Northwestern University Feinberg School of Medicine Chicago Illinois USA

12. Department of Population Health Kansas University Medical Center Kansas City Kansas USA

13. Departments of Urology and Population Health New York University Langone Health New York USA

14. Manhattan Veterans Affairs Medical Center New York New York USA

15. New York University Rory Meyers College of Nursing New York New York USA

16. Department of Urology Yale School of Medicine New Haven Connecticut USA

Abstract

AbstractIntroductionAlthough prostate magnetic resonance imaging (MRI) is commonly used in the diagnosis, staging and active surveillance of prostate cancer, little is known about patient perspectives on MRI.MethodsWe performed a qualitative study consisting of in‐depth, semi‐structured interviews of patients with low‐ and intermediate‐risk prostate cancer managed with active surveillance. Interviews focused on experiences with and knowledge of prostate MRI and MRI‐ultrasound fusion biopsy during active surveillance. We purposively sampled patients who received prostate MRI as part of their clinical care, conducted interviews until reaching thematic saturation and performed conventional content analysis to analyse data.ResultsTwenty patients aged 51–79 years (mean = 68 years) participated in the study. At diagnosis, 17 (85%) had a Gleason grade group 1, and three (15%) had a grade group 2 tumour. Overall, participants viewed prostate MRI as a valuable tool that accurately localizes and monitors prostate cancer over time, and they considered prostate MRI central to active surveillance monitoring. We identified five thematic categories related to MRI use: (1) the experiential aspects of undergoing an MRI scan; (2) the experience of visualizing one's own prostate and prostate cancer; (3) adequacy of provider explanations of MRI results; (4) confidence in prostate MRI in decision‐making; and (5) the role of prostate MRI in longitudinal follow‐up, including an interest in using MRI to modify the timing of, or replace, prostate biopsy.ConclusionPatients value prostate MRI as a tool that enhances their confidence in the initial diagnosis and monitoring of prostate cancer. This work can inform future studies to optimize patient experience, education and counselling during active surveillance for prostate cancer.

Publisher

Wiley

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