Psychological aspects of active surveillance

Aim The objective of this paper was to discuss the psychological impact of active surveillance (AS) for prostate cancer (PCa) and the resulting implications of psychological wellbeing for treatment decision making and acceptance of AS protocols. Method Qualitative and quantitative research in the area of anxiety, depression, and distress is discussed drawing from PCa literature as well other health conditions from which parallels can be drawn. Results Attention is given to the role of the clinician in treatment decision making, including the value of information provision, and perceived trust in the AS as a management approach. Conclusion Given that research is conflicted regarding the psychological impact of AS for PCa, it is suggested that focus shifts away from debate of the ‘true’ experience of AS rather researchers and clinicians should seek to identify the factors associated with positive and negative psychological response to diagnosis and AS to improve psychological and physical outcomes. Recommendations for clinical practice are discussed.