Mindfulness-Based Cognitive Therapy in Advanced Prostate Cancer: A Randomized Controlled Trial

Chambers, Suzanne K. and Occhipinti, Stefano and Foley, Elizabeth and Clutton, Samantha and Legg, Melissa and Berry, Martin and Stockler, Martin R. and Frydenberg, Mark and Gardiner, Robert A. and Lepore, Stephen J. and Davis, Ian D. and Smith, David P. (2017) Mindfulness-Based Cognitive Therapy in Advanced Prostate Cancer: A Randomized Controlled Trial. Journal of Clinical Oncology, 35 (3). pp. 291-297. ISSN 0732-183X


Abstract

Purpose
Advanced prostate cancer (PC) is associated with substantial psychosocial morbidity. We sought to determine whether mindfulness-based cognitive therapy (MBCT) reduces distress in men with advanced PC.

Methods
Men with advanced PC (proven metastatic and/or castration-resistant biochemical progression) were randomly assigned to an 8-week, group-based MBCT intervention delivered by telephone (n = 94) or to minimally enhanced usual care (n = 95). Primary intervention outcomes were psychological distress, cancer-specific distress, and prostate-specific antigen anxiety. Mindfulness skills were assessed as potential mediators of effect. Participants were assessed at baseline and were followed up at 3, 6, and 9 months. Main statistical analyses were conducted on the basis of intention to treat.

Results
Fourteen MBCT groups were conducted in the intervention arm. Facilitator adherence ratings were high (> 93%). Using random-effects mixed-regression models, intention-to-treat analyses indicated no significant changes in intervention outcomes or in engagement with mindfulness for men in MBCT compared with those receiving minimally enhanced usual care. Per-protocol analyses also found no differences between arms in outcomes or engagement, with the exception of the mindfulness skill of observing, which increased over time for men in MBCT compared with usual care (P = .032).

Conclusion
MBCT in this format was not more effective than minimally enhanced usual care in reducing distress in men with advanced PC. Future intervention research for these men should consider approaches that map more closely to masculinity.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions
Date Deposited: 05 Jul 2022 09:19
Last Modified: 12 Jul 2022 01:17
Uncontrolled Keywords: stress reduction, men, intervention, survivors, metaanalysis, feasibility, depression, efficacy, anxiety, health
Fields of Research (2008): 11 Medical and Health Sciences > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified
Fields of Research (2020): 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321199 Oncology and carcinogenesis not elsewhere classified
Identification Number or DOI: https://doi.org/10.1200/JCO.2016.68.8788
URI: http://eprints.usq.edu.au/id/eprint/49403

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