Presurgery experiences of prostate cancer patients and their spouses

PURPOSE: In this article, the authors describe the experiences of men with prostate cancer and their spouses between diagnosis and surgery. DESCRIPTION: As part of a longitudinal qualitative study, semistructured in terviews were held with 34 prostate cancer patients who were waiting for su rgery. Separate interviews were held with their spouses. RESULTS: Six main components of experience were evident from the analysis o f transcripts related to the presurgery period; 1) the news of a diagnosis of prostate cancer came initially as a shock for both partners, the impact of which lessened over time; 2) the new reality of illness necessitated rea ddressing the marital relationship, most often resulting in a sense of rene wed connection and commitment; 3) the illness crisis precipitated a search for information to guide decisions about treatment; 4) there was a need for couples to decide who to inform about the cancer diagnosis and how much to say about it; 5) couples attempted to seek a semblance of normality in the ir lives, especially after treatment decisions had been made; and 6) despit e attempts to minimize the potential impact of upcoming surgery, anxiety wa s typically experienced at least intermittently by one or both partners. CLINICAL IMPLICATIONS: Physicians, nurses, social workers, and other health professionals need to facilitate attempts by the patient to gather and syn thesize information. Cancer specialists can play a positive role in reducin g distress in couples, and, thus, the attention of the specialists to commu nication issues is critical. The strain of waiting for surgery must be cons idered when treatment recommendations are made; watchful waiting protocols require further study from a psychological perspective. Clinicians need to be alert to the balance between being positive and carrying on as normal, a nd acknowledging and dealing with the distress that arises.