Objective: In the past decade localized prostate cancer (LPC) management has been shifting from three radical treatment options (radical prostatectomy, external beam radiotherapy, or brachytherapy) to also include active surveillance (AS). This study examines men with LPC and partners' experiences of choosing between AS and radical treatments, and their experiences of AS when selected.Methods: Qualitative descriptive research design. Interviewed participants were men, and partners of men, who had either chosen radical treatment immediately following diagnosis, or who had been on AS for at least three months. AS was the recommended treatment. Transcribed interviews were thematically analysed and inter-rater reliability integrated.Results: Twenty-one men and 14 partners participated. Treatment decisions reflected varied reactions to prostate cancer information, regularly described as contradictory, confusing, and stressful. Men and partners commonly misunderstood AS but could describe monitoring procedures. Partners often held the perception that they were also on AS. Men and partners usually coped with AS but were sometimes encumbered by treatment decision-making memories, painful biopsies, ongoing conflicting information, and unanswered medical questions. Radical treatment was selected when cancer progression was feared or medically indicated. Some preferred doctors to select treatments.Conclusions: To reduce distress frequently experienced by men diagnosed with LPC and their partners during treatment decision-making and ongoing AS monitoring, the following are needed: improved community and medical awareness of AS; consistent information about when radical treatment is required; and consistent, unbiased information on treatment options, prognostic indicators, and side effects. Regularly up-dated decisional support information/aids incorporating men's values are imperative.

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Despite the prolonged survival of many patients with advanced cancer and the increasing conceptualization of cancer as a chronic illness, care delivery systems within the Australian context continue to manage advanced cancer as an acute illness. Patients living with advanced cancer are managed alongside those with curable cancers in ambulatory models of care that centre on diagnosis, treatment decision-making or post treatment surveillance. Conversely, the needs of people with advanced disease are often complex, requiring high levels of collaboration between providers across acute, palliative and primary care settings in order to move forwards to a more person-centered approach to care. Aims: This paper addresses three specific aims: 1. to identify the care requirements and concerns of patients and their carers; 2. to examine the role of out-reach telephone calls as a component of care; 3. to identify the nurse's role in care coordination for patients with advanced cancer. Method: Two nurse clinician researchers (CR) managed a cohort of patients with advanced breast (n=12) and gastrointestinal cancers (n=16) over six and nine months respectively. Data were recorded on every interaction between the CRs and the patients, carers and other health professionals. The CRs were interviewed by an independent nurse researcher. Results: The symptoms and issues causing concern to patients and/or carers included pain, weakness, gastrointestinal symptoms, managing appointments and dealing with anxiety. The CR played a major role in coordinating care to address these concerns and found out-reach telephone calls facilitated the process. Conclusions: Patients with advanced cancer have complex needs and care coordination requirements not routinely met in an acute care setting. Input from a nurse working at an advanced level and the use of out-reach telephone calls can assist in meeting these care needs.

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