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A Qualitative Analysis of Interviews of Men With Early Stage Prostate Cancer: The Prostate Cancer Lifestyle Trial

Kronenwetter, Carol PhD; Weidner, Gerdi PhD; Pettengill, Elaine PhD, RN; Marlin, Ruth MD; Crutchfield, Lila RN; McCormac, Patricia RN; Raisin, Caren J. RN; Ornish, Dean MD

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We conducted interviews with a subsample of men (n = 26) participating in the Prostate Cancer Lifestyle Trial (PCLT), who had biopsy-proven prostate cancer (Gleason grade <7; prostate-specific antigen 4–10 ng/mL) and chose “watchful waiting” after diagnosis. The PCLT aimed at improving diet, exercise, stress management practices, and group support within a peer community setting. The aims of this study were to examine psychological, emotional, spiritual, and social reactions to (a) a diagnosis of early stage prostate cancer and (b) participation in the PCLT. Qualitative analyses were completed using MAXqda. Results indicated that the cancer diagnosis was met with anxiety, distress, and denial, or a “bump in the road” attitude. There was some indication that conflict with partners was exacerbated by the diagnosis. A significant component of the lifestyle intervention was involvement in the peer community. This community provided opportunities to experience connections with others facing similar health difficulties. Men generally expressed positive attitudes (emotionally, physically, and spiritually) about the lifestyle change, and felt that their participation in the program contributed to feelings of hope, optimism, and fighting spirit. Additionally, participants frequently mentioned increased comfort with emotional expression.

From the Preventive Medicine Research Institute, Sausalito, Calif (Dr Weidner, Dr Marlin, Ms Crutchfield, Ms McCormac, Ms Raisin, and Dr Ornish); and the Comprehensive Cancer Center (Dr Kronenwetter) and the Department of Physiological Nursing (Dr Pettengill), University of California, San Francisco, Calif.

Corresponding author: Gerdi Weidner, PhD, Preventive Medicine Research Institute, 900 Bridgeway, Sausalito, CA 94965 (e-mail: gerdi.weidner@pmri.org).

This study was supported by a generous grant from the George Family Foundation. Major support for the PCLT to determine the effects of diet and lifestyle changes on the progression of prostate cancer was provided by grants from the Department of Defense Uniformed Services University (USU Grant No. MDA905-99-1-0003) via the Henry M. Jackson Foundation (Grant # 600-06971000-236) and by CapCURE, the Resnick Foundation, The Walton Family Foundation, the Wachner Foundation, the Ellison Foundation, the Koch Foundation, and the Wynn Foundation. Additional support was provided by the Eichenberg Foundation, the Finlay Foundation, the Hayden Foundation, the Fisher Foundation, the Kerzner Foundation, the Goldman Foundation, and the Gallin Foundation. None of these foundations were involved in the design or conduct of the study, in the collection, analysis, or interpretation of the data, or in the preparation, review, or approval of the manuscript.

Accepted for publication November 8, 2004.

© 2005 Lippincott Williams & Wilkins, Inc.