Meanings of prostate-specific antigen testing as narrated by men with localized prostate cancer after primary treatment

Abstract

Objective. To illuminate the meanings of prostate-specific antigen (PSA) testing as narrated by men with localized prostate cancer (LPC) after primary treatment. Material and methods. Fifteen men were interviewed in their homes. The narrative interview text was analyzed using a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur. Results. Life after treatment for LPC means feeling unsafe because of being affected by a life-threatening and unpredictable disease, characterized by a lack of early signs of progression. In this situation, PSA testing is ascribed as providing a sense of control to enable one to achieve a feeling of safety. Thus one meaning of PSA testing is receiving a message about the status of the body; another is a tense waiting related to fear of the results. A low, stable PSA value is interpreted as a sense of being safe based on confidence in the PSA tests and a sense of having control over the LPC via regular PSA testing. A rising value of the PSA blood test is understood as an indication of progression of the disease, but confidence in PSA testing also means that when the PSA value rises there is a sense of catching the cancer in good time. Conclusions. The comprehensive understanding of the meaning of PSA testing can be understood in terms of a lifeline to cling to when wondering whether the cancer is still in progress in the body or whether the treatment has been curative. This lifeline creates a feeling of security in a post-treatment life situation which is experienced as being unsafe.