Decision-Making Control: Why Men Decline Treatment for Prostate Cancer

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Abstract
The purpose of this study was to conduct a qualitative analysis of decision-making control by men with prostate cancer who refuse conventional cancer therapies. The transcripts for 8 prostate cancer patients from a larger qualitative study were analyzed separately to explore in depth the factors related to decision-making control. Results. Most men were newly diagnosed when they made the decision to forgo conventional cancer treatment in favor of alternative approaches. Five areas were identified in which patients took control over the treatment process. These include control over (1) the timing of treatment, (2) information about conventional treatment and risk assessment, (3) designing an alternative treatment plan, (4) coordination of cancer care, and (5) monitoring and evaluation of disease progression. Clinicians can support patients who delay or forgo treatment for prostate cancer by helping them maintain a sense of control over the treatment process. This can be achieved by supporting patients' efforts to integrate complementary therapies into their cancer care, by addressing fears related to treatment early in the decision-making process, and by encouraging open communication about the reasons for seeking alternatives to conventional treatment. Findings from this study need to be evaluated in a larger, quantitative study.