To what extent can response shift theory explain the variation in prostate cancer patients' reactions to treatment side-effects? A review

There appears to be a conflict between published literature and in vitro evidence concerning the effects of treatment-induced side-effects on prostate cancer patients. There is an existing body of research which indicates evidence for a phenomenon whereby quality-of-life scores of patients' post-treatment reflect no difference to healthy controls and are perhaps even higher than before treatment, despite the substantial side-effects such as sexual and urinary dysfunction. However, when observing clinical patients at Good Hope Hospital urology clinic, it appears that whilst patients are seemingly unaffected by the threat of sexual and urinary side-effects of treatment at diagnosis, they become increasingly concerned about these consequences following treatment, indicating evidence for a response shift in the opposite direction. This phenomenon is investigated here. Thirteen papers were selected for review and considered in terms of their contribution to research into response shift as a coping process and in particular, response shift in prostate cancer. Based on the existing literature, an underlying model is formulated for the moderation of the extent and direction of prostate cancer patients' response shift, incorporating the function of external influences such as perceived social support.