Health Professionals’ Perceptions about Prostate Cancer—A Focus Group Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Ethical Approval
2.2. Setting and Sample
2.3. Study Design
2.4. Analysis
3. Results
3.1. Participants
3.2. Themes and Subthemes
3.3. Perceptions about Prostate Cancer
“[PSA screening] is also linked to that idea of having a check-up”.(FG1P6)
“When they come to request a medical check-up [they say]: «Look, don’t forget the PSA for the prostate», every time”.(FG2P3)
“Private health marketing includes the recommendation of the PSA, no doubt”.(FG1P1)
“This movement emerged in […] November. Movember has gone viral, and I think it affects all generations a bit”.(FG2P2)
“…what we realize is that it may not be annually, but from the moment it [PSA screening] happens for the first time, and they ask for medical check-ups, even if only every 2 years, the PSA is always present”.(FG3P4)
3.4. Perceptions of Prostate Cancer Risk Factors
“The risk factors are familiar history and age, and these are the risk factors to consider, at least those that have been established so far. Possible genetic mutations […] Afro-descendant patients have a propensity for a higher incidence, as their race is a risk factor”.(FG3P1)
“PCa often happens at older ages. Changing habits at 70, 80 years old is very difficult and it is very difficult to start this conversation [of changing lifestyle habits] when approaching PCa”.(FG1P3)
3.5. Nutritional Impact on Prostate Cancer
“Anything contrary to the dietary pattern of a Mediterranean diet will lead to a higher risk of PCa and inflammation in general”.(FG1P1)
“More pro-inflammatory foods may increase the aggressiveness or progression of neoplastic diseases […] fast-absorbing sugars are more pro-inflammatory than slow-absorbing ones”.(FG2P1)
“…there are many currents that argue, for example, dairy products cause more inflammation, red meat as well, while nutrients such as lycopene, which is present in tomatoes, could help prevent this”.(FG2P2)
“Foods […] with antioxidant properties that have the opposite effect [...] lycopene, which is present in tomatoes, […] at least has some evidence in reducing the risk of PCa”.(FG1P1)
3.6. Physical Activity Role in Prostate Cancer
“In general, cardiovascular exercise, due to its anti-inflammatory effects, […] is not only due to the circulatory part itself but due to the effect of the release of anti-inflammatory factors”.(FG1P4)
“Now there are many studies just about strength training, also to complement the cardiovascular part”.(FG1P3)
“Walks and exercises like water aerobics, pilates or yoga, which are often available at senior universities and cultural associations”.(FG3P4)
“All contact sports should be avoided”.(FG3P1)
3.7. Alcohol Consumption and Smoking
“…they have a clear idea that tobacco is harmful, so probably if we asked them «do you think tobacco is harmful to PCa?», I think the majority would answer yes, considering that tobacco is bad for health”.(FG3P4)
3.8. Sexual Activity and Sexually Transmitted Diseases
“The agents that most frequently cause chronic prostatitis are gonorrhea and chlamydia. Prostatitis, being a pro-inflammatory environment of the prostate, in theory, increases the risk of PCa, simply because the environment of those cells is conducive to the development of mutations and divisions and all that […] it is very difficult to establish a causal relationship because there are many undiagnosed sexually transmitted diseases and PCa is relatively common.”.(FG1P3)
“Men, in general, always have this concern in the first place, even more than mortality itself”.(FG1P2)
“Patients establish a relationship between the possible appearance of PCa and the appearance of erectile dysfunction”.(FG3P1)
3.9. Screening/Diagnosis and Treatment Methods
“If the rules are well explained, it is a very reliable method”.(FG2P7)
“I wish there was a better method, because the PSA is one of the most frustrating things for me, because it’s almost good until it isn’t”.(FG1P3)
“They already come many times with knowledge of family members, they already know what these family members did, what their treatments were, and, in that sense, they have an idea”.(FG3P3)
“Many groups are dedicated precisely to trying to obtain a new biomarker…obviously, the ideal would be a non-invasive method, right? Ideally in the urine”.(FG3P1)
Perceptions about PCa | Patients have a basic understanding of PCa, its primary screening method, and at what age they should undergo screening |
Men are more likely to request screening at earlier stages if they have family or friends with PCa | |
Heightened awareness can be due to private health marketing and awareness campaigns (Movember) | |
Men > 75 years should not undergo PSA screening unless they exhibit symptoms or have important comorbidities, and a life expectancy above 10–15 years | |
Patients are aware of benign prostatic hyperplasia (BPH) symptoms but earlier stages of PCa do not present symptoms | |
Patients undervalue PCa symptoms as they usually link them to other health conditions | |
Socioeconomic factors affect PCa health literacy | |
Perceptions about PCa risk factors | Age, family history, genetic alterations, and black race are the most recognized risk factors |
Lifestyle factors are considered possible contributors to PCa development | |
Health professionals do not expect their patients to adopt lifestyle changes, especially at older ages | |
Several qualitative studies demonstrate that when facing a PCa-positive diagnosis, men tend to adopt healthier lifestyles, especially if advised by their GP | |
If patients were advised to alter their habits, they could prevent PCa or, at least, achieve better treatment outcomes. | |
Perceptions on the association between lifestyle and PCa | Diets rich in vegetables (tomatoes) and fruits, and low in saturated fats and fast-absorbing carbohydrates, are judged to reduce PCa risk and are recommended by the participants |
After facing a positive PCa diagnosis, men tend to avoid processed food, red meat, and salt intake and improve the consumption of green tea, olive oil, fruits, and vegetables, mainly tomatoes and broccoli (Mediterranean patterns) | |
Cardiovascular exercise, like brisk walking, water aerobics, pilates, and yoga are recommended for older patients, while contact sports should be avoided | |
Older men would be more motivated to engage in physical activities if they received exercise support | |
Exposure to alcohol and tobacco at younger ages could promote oxidative stress and negatively affect PCa progression | |
PCa’s effect on sexual performance has become a major concern for men, resulting in screening avoidance until symptoms of sexual impotence emerge | |
Screening/diagnosis and treatment methods | PSA is the best available screening method when patients comply with the recommended precautions, but should be performed along with DRE |
PSA has remained a controversial screening method due to its limitations, overdiagnosis, and overtreatment | |
Need for new biochemical biomarkers, highlighting the necessity of urine biomarkers as potential non-invasive screening/diagnostic tools for PCa | |
PCa treatments often lead to urinary incontinence, urinary urgency, rectal diastasis, sexual dysfunction, fatigue, and weakness | |
Alternative treatment methods include an accurate imaging method or the promising field of immunotherapy and brachytherapy (the application remains experimental) |
4. Discussion
4.1. Perceptions about Prostate Cancer
4.2. Perceptions of Prostate Cancer Risk Factors
4.3. Perceptions of the Association between Lifestyle Factors and Prostate Cancer
4.4. Perceptions of the Screening/Diagnosis and Treatment Methods
4.5. Limitations and Strengths
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | n | Percentage (%) |
---|---|---|
Total Participants | 21 | 100% |
Gender | ||
Men | 10 | 47.6% |
Women | 11 | 52.4% |
Age | ||
18–29 | 11 | 52.4% |
30–39 | 7 | 33.3% |
40–49 | 2 | 9.5% |
Medical Specialty | ||
GPs | 20 | 95.2% |
Urologists | 1 | 4.8% |
Professional experience | n | Mean ± SE |
Years of experience | 19 | 4.8 ± 4.26 |
Appointments per month | 11 | 375.7 ± 122.34 |
Theme | Subtheme |
---|---|
Perceptions about prostate cancer (PCa) | Age at first PCa screening and frequency |
Symptoms | |
Impact of socioeconomic factors | |
Reasons for PCa screening | |
Perceptions of PCa risk factors | Risk factors acknowledged by participants |
Patients’ knowledge about risk factors | |
Willingness to change lifestyle habits | |
Nutritional impact on PCa | Diets that aggravate PCa |
Diets that prevent PCa | |
Supplementation prescription | |
Willingness to change diets | |
Physical activity (PA) role in PCa | PA recommendation and prescription |
PA to prevent PCa | |
Willingness to become more active | |
Alcohol consumption and smoking | Young-age exposure to alcohol |
Young-age exposure to smoking | |
Patients’ perceptions | |
Sexual activity and sexually transmitted diseases (STDs) | Impact of sexual activity on PCa |
Impact of PCa on sexual performance | |
Screening, diagnosis, and treatment methods | Screening/diagnosis methods perceptions |
Alternative diagnosis methods | |
Treatment methods perceptions | |
Alternative treatment methods |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Leitão, C.; Estrela, M.; Monteiro, L.; Fardilha, M.; Herdeiro, M.T.; Roque, F. Health Professionals’ Perceptions about Prostate Cancer—A Focus Group Study. Cancers 2024, 16, 3005. https://doi.org/10.3390/cancers16173005
Leitão C, Estrela M, Monteiro L, Fardilha M, Herdeiro MT, Roque F. Health Professionals’ Perceptions about Prostate Cancer—A Focus Group Study. Cancers. 2024; 16(17):3005. https://doi.org/10.3390/cancers16173005
Chicago/Turabian StyleLeitão, Catarina, Marta Estrela, Luís Monteiro, Margarida Fardilha, Maria Teresa Herdeiro, and Fátima Roque. 2024. "Health Professionals’ Perceptions about Prostate Cancer—A Focus Group Study" Cancers 16, no. 17: 3005. https://doi.org/10.3390/cancers16173005