Prostate Cancer and Its Influence on Men´s Daily Lives

Abstract: Prostate cancer has been a disease of older men but age at diagnosis is falling in Sweden. Fatigue has been regarded as a common symptom of cancer and may compromise quality of life in prostate cancer patients. The overall purpose of this thesis was to identify and describe fatigue and its influence on men’s lives when undergoing examinations for suspected prostate cancer and diagnosed with prostate cancer. Further, the purpose was to understand if prostate cancer affects the men’s daily lives. The data were collected consecutively at the outpatient clinics of two different hospitals in Sweden. Data from qualitative interviews using the same topics, with modification in paper IV, were analysed by Gadamer´s hermeneutics. Paper I: Eleven men undergoing routine examination for prostate cancer (transrectal ultrasound and biopsy), but diagnosed as having benign disease were interviewed during the spring of 2002. At the time of the prostate cancer examination, the men did not feel fatigue, i.e. not because of the examination; they felt healthy. Paper II: Sixteen men newly (within 2-4 weeks) diagnosed as having localized prostate cancer and with a prostate-specific antigen level of <10 ng/ml and untreated at the time of the interview participated between spring and autumn 2003. Most of the men did not experience fatigue due to the diagnosis but experienced every day fatigue and cancer influenced the men´s daily lives. The men felt healthy. Paper III: Ten men newly (within 2-4 weeks) diagnosed as having advanced prostate cancer PSA of > 100 ng/ml and treated for no more than 2 weeks at the time of the interview participated between autumn 2003 and December 2005. The men did not experience fatigue due to advanced prostate cancer but they experienced normal every day fatigue. The men felt healthy with some dysfunction influencing their daily lives. Paper IV: All 22 men who were still alive since the first interview (in studies II and III) were followed up between May 2005 and November 2007. The men were living with a sense of feeling healthy, even when having lived with prostate cancer for approximately two years; both cancer stage and age had an influence on them. All the men experienced Every Day Fatigue. Conclusions: Personality and anxiety contributed to fatigue when undergoing examination for suspected prostate cancer. Localized prostate cancer affected the men´s emotions and contacts giving them a new perspective on life. Advanced prostate cancer affects men´s lives: they are placed in a new life situation, against their will, and in this new situation, they form a new life perspective. The follow-up study confirmed the men´s view that age influences them, they live with uncertainty but with strengthened self-esteem, finding a balance in a changed life situation. According to the present studies the men felt healthy in spite of prostate cancer. Complementary findings were found about existential thoughts. Health professionals have a unique position to identify the different stages of the men´s adaptation to prostate cancer to guide them towards their individual needs at each stage of their adjustment.