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Twenty-one patients across three countries participated in four focus groups or seven semi-structured interviews, conducted in participants’ native languages, recorded, transcribed, and thematically analysed to build a codebook and identify themes. Results show participants want active involvement, yet emotional strain and often rapid decisions make engagement challenging. Twelve themes were identified, emphasizing empowerment, health literacy, support, fear of recurrence, trust, shared decision making, communication, and administrative issues.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/navigating-choices-understanding-the-decision-making-journey-of-patients-with-localised-kidney-cancer/371466/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/navigating-choices-understanding-the-decision-making-journey-of-patients-with-localised-kidney-cancer/371466.png","ImageObject",300,407,{"name":92,"@type":93},"\tCallum ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study’s objective?","Question",{"text":113,"@type":114},"To explore patients’ experience of decision making regarding treatment of localised kidney cancer.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were participants and interviews conducted?",{"text":118,"@type":114},"A total of 21 patients in three countries joined four focus groups or seven semi-structured interviews, averaging 2 hours. Sessions were recorded, transcribed, and translated into English when applicable, then analysed thematically.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the study find about patient involvement?",{"text":122,"@type":114},"All participants expressed a desire to be actively involved, but emotional toll and the need for quick decisions made active engagement challenging.",{"name":124,"@type":111,"acceptedAnswer":125},"What gap did the conclusions highlight?",{"text":126,"@type":114},"A significant gap between research recommendations and clinical practice, emphasizing translation of research findings into clinical application to enhance patient-centred care.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},371466,1790639756,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},137451211410,"https://ap-avatar.wpscdn.com/avatar/2000bb0a9246f588df?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786362646172706240","BJU Int 2025; 135: 953–959 doi:10.1111/bju.16635  \nOriginal Article  \nNavigating choices: understanding the decision-making journey of patients with localised kidney cancer  \nKatharina Beyer 1,5 , Lionne D.F. Venderbos1 , Monique J. Roobol 1 , Rachel H. Giles2, Paul Verhagen1, Ravi Barod4, Lisa M. Wintner7, Michael A.S. Jewett3, Mieke Van Hemelrijck5  and Netty Kinsella6  \n1Department of Urology, Erasmus MC Cancer Institute Erasmus University Medical Center Rotterdam, Rotterdam, 2Department of Endocrine Oncology, Cancer Center, University Medical Center Utrecht, 3International Kidney Cancer Coalition, Utrecht, The Netherlands, 4Specialist Centre for Kidney Cancer, Royal Free Hospital, 5 Translational Oncology and Urology Research (TOUR), King ’s College London, 6Department of Urology, Royal Marsden Hospital, London, UK, and 7Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria  \nObjective  \nTo explore patients’ experience of decision making regarding treatment of localised kidney cancer.  \nMethods  \nA total of 21 patients with localised kidney cancer, across three countries, participated in either four focus groups or seven semi-structured interviews that lasted on average 2 h. Focus groups and interviews were all conducted in the participants’native language, recorded, transcribed and (if applicable) translated into English. Thematic analysis was used to develop acodebook and identify themes.  \nResults  \nAll participants expressed a desire to be actively involved in the treatment decision-making process. However, due to the emotional toll of the cancer journey, which often necessitates quick decisions, actively engaging in the decision-making process was described as challenging. The study revealed 12 key themes. These themes included the impact of diagnostic paths, patient characteristics, patient empowerment, health literacy, source of support, fear of recurrence, trust in treatment and healthcare providers, shared decision making (SDM), professional interaction, personal belief system, and organisational and administrative issues.  \nConclusions  \nThe findings highlight the complexity of decision making, underscoring the desire for patient involvement, SDM, and clear communication. We reveal a significant gap between research recommendations and clinical practice, emphasising the need to translate research findings to clinical application to enhance patient-centred care.  \nKeywords  \nkidney cancer, treatment decision making, shared decision making, active surveillance, nephrectomy, ablation  \nIntroduction  \nIn the last two decades, the number of patients diagnosed with small kidney masses has more than doubled, with most of the tumours smaller than 4 cm in size. Despite the small size, 80% of these kidney tumours are malignant [1,2] . Evidence has established that, even if cancerous, these small tumours might not spread or grow, meaning patients may never need invasive treatments [3] . In clinically fit patients, nephron-sparing surgery is the standard treatment for small kidney cancers. However, less invasive treatments such as  \nablation (i.e., radiofrequency ablation and cryoablation) or active surveillance (i.e., closely monitoring for evidence of progression) are now available as well [4,5] . These treatment alternatives are associated with different risks and side effects. Surgery is effective but with risk of complications (e.g., bleeding) and treatment-related long-term side effects, such as reduced kidney function (e.g., chronic kidney disease) . Ablative techniques may result in residual tumour requiring salvage treatment and may produce side effects, such as injury to normal kidney [6–8] . Active surveillance is a safe option for carefully selected patients with slow growth rates  \n􀀁 2025 The Author(s) .  \nBJU International published by John Wiley & Sons Ltd on behalf of BJU [International. www.bjui.org](International. www.bjui.org) [wiley","cbCaijjgCy6oaDMP","https://ap.wps.com/l/cbCaijjgCy6oaDMP","pdf",555434,"English","# Objective\n# Methods\n## Design and Ethical Approval\n# Results\n# Conclusions\n# Introduction","[{\"question\":\"What was the study’s objective?\",\"answer\":\"To explore patients’ experience of decision making regarding treatment of localised kidney cancer.\"},{\"question\":\"How were participants and interviews conducted?\",\"answer\":\"A total of 21 patients in three countries joined four focus groups or seven semi-structured interviews, averaging 2 hours. Sessions were recorded, transcribed, and translated into English when applicable, then analysed thematically.\"},{\"question\":\"What did the study find about patient involvement?\",\"answer\":\"All participants expressed a desire to be actively involved, but emotional toll and the need for quick decisions made active engagement challenging.\"},{\"question\":\"What gap did the conclusions highlight?\",\"answer\":\"A significant gap between research recommendations and clinical practice, emphasizing translation of research findings into clinical application to enhance patient-centred care.\"}]","Navigating choices - understanding the decision-making journey of patients with localised kidney cancer | PDF",1790192138,18]