Men undergoing AS live every day with the knowledge that they have cancer in their bodies
(Hedestig, Sandman, & Widmark, 2003). When they are asymptomatic or experience only
occasional signs that cancer is present, their uncertainty about the state of the cancer may be
intense. A defining characteristic of that uncertainty is the fact that prostate cancer offers
few signals for men as they try to monitor the progression of their illness. Without markers
of disease, some men incorrectly attribute benign physical changes to disease progression
(Bailey et al., 2007). For example, they may associate common arthritic pain with bony
metastases, or attribute a change in sexual function to advancing disease. Others, who
experience no physical discomfort, may find it hard to believe that the cancer really exists
(Bailey et al., 2007). If AS is to succeed as a viable treatment alternative, researchers and
clinicians must have adequate tools to measure the effect of uncertainty during the AS
process, as a basis for developing and evaluating of interventions to manage the uncertainty.
This article reports secondary analysis of pooled data from four separate studies testing the
reliability and validity of the Mishel Uncertainty in Illness Scale Community form (MUISC;
Mishel, 1997b) instrument for use with men undergoing AS for prostate cancer and its
potential for serving as a measure of intervention effectiveness.