Cancer Control Research5R21CA102761-02
Penedo, Frank J.
QUALITY OF LIFE INTERVENTION IN ADVANCED PROSTATE CANCER
DESCRIPTION (provided by applicant): This is a two-year study designed to evaluate the efficacy of a ten-week cognitive behavioral stress and affect management (CBSAM) intervention on quality of life and physical functioning in men with advanced (i.e., metastatic disease) prostate cancer (MFC) relative to participants receiving a health promotion (HP) intervention. Men living with MPC endure an illness with a chronic and debilitating course that can impact many facets of an individual's quality of life. There is growing evidence suggesting that among cancer patients, psychosocial factors (e.g., appraisals, coping, social support, and depression) may mediate relations among distress and quality of life. Because MPC is primarily a disease of older men, we propose to deliver the CBSAM intervention through a telecommunications system (i.e., Telecare) designed to enhance access to formal and informal care for a population that may have difficulty accessing traditional psychotherapeutic settings. In our prior work with men following surgical (i.e., radical prostatectomy) or radiation treatment for localized prostate cancer, we have shown that (a) psychosocial factors such as distress, depression, social isolation, coping and perceived stress are related to poor quality of life, and that (b) a ten-week, group-based cognitive-behavioral intervention can reduce distress and improve coping strategies. Furthermore, the Telecare system has been successful in delivering a supportive intervention for older caregivers of dementia patients. This study is designed to expand our current work to men living with MPC (N=120) as this group is at risk for psychosocial distress and poor quality of life, and may have difficulty accessing traditional treatment settings for psychosocial interventions. The study involves a 2 X 3 randomized experimental design with group (CBSAM, n=60 vs. HP, n=60) as the between-group factor, and time (Pre-intervention, Post-Intervention and six-month follow-up) as the within-group factor. Our primary objective is to evaluate the extent to which a CBSAM intervention aimed at building skills in anxiety and arousal reduction, distress tolerance, accurate stressor appraisals, adaptive coping strategies, better health care attitudes, positive growth and the use of efficacious social networks may reduce depression, distress, and social isolation with associated improved quality of life and physical functioning outcomes.