OBJECTIVES: To depict the journey of metastatic prostate cancer patients from the first symptom /abnormal finding until diagnosis and current treatment.

METHODS:A qualitative study was performed during January - May 2018, using a semi-structured interview guide. Men with a diagnosis of metastatic prostate Ca after 2015 were eligible to participate. Participants were recruited through public and private hospital clinics in Attica, Greece. The interviews were recorded with the participants' written consent, transcribed and content analyzed.

RESULTS: 10 men participated in the study (mean age 66 years). 6/10 were initially diagnosed with metastatic prostate Ca. For 4/6 patients the metastasis was diagnosed 3 months - 3.5 years after their initial diagnosis. All participants had bone metastasis. Participants with an initial diagnosis of metastatic Ca sought medical advice because of symptoms (urinary problems, pain in the bones, back pain) or an abnormal result in their PSA test. Prolonged intervals for seeking medical attention were reported in some cases as patients attributed their symptoms to other causes or did not prioritize their health problems. Because of the nature of symptoms, patients report first consulting with physicians of various specialties. An urologist sets the diagnosis and subsequently refers them to an oncologist. The choice of oncologist is an important milestone, as patients rely on him/her to make all treatment-related decisions. Participants appreciate physicians that communicate effectively with patients and are sensitive to their feelings. Metastatic prostate Ca has various implications for their personal, family and social life. The majority of participants did not seek professional services as they felt they could rely on themselves, their families and close friends for support.

CONCLUSIONS: the present study provided useful insights regarding the symptom appraisal and help-seeking behaviors of patients with metastatic prostate Ca as well as the disease impact on patients’ lives.