A randomised controlled trial of a mindfulness intervention for men with advanced prostate cancer

Suzanne K Chambers,David P Smith,Robert Mcdowall,Martin Berry,Stephen J Lepore,Robert A Gardiner,Samantha Clutton,Stefano Occhipinti,Elizabeth Foley,Mark Frydenberg

doi:10.1186/1471-2407-13-89

Abstract

BackgroundProstate cancer is the most common male cancer in developed countries, and in Australia approximately one-fifth of men with prostate cancer have advanced disease. By comparison to men with localised prostate cancer, men with advanced disease report higher levels of psychological distress; poorer quality of life; and have an increased risk of suicide. To date no psychological intervention research specifically targeting men with advanced prostate cancer has been reported. In this paper we present the protocol of a current randomised controlled trial to assess the effectiveness of a professionally-led mindfulness-based cognitive therapy (MBCT) group intervention to improve psychological well-being in men with advanced prostate cancer.Methods/designNinety-five men per condition (190 men in total) will be recruited through clinicians in the Australian and New Zealand Urogenital and Prostate Cancer Trials Group and in major treatment centres in Queensland, New South Wales, Victoria and Western Australia. Patients are randomised to: (1) tele-based MBCT intervention or (2) patient education. A series of previously validated and reliable self-report measures will be administered to men at four time points: baseline/recruitment, and at 3, 6, and 9 months after recruitment and intervention commencement. Engagement with the principles of mindfulness and adherence to practice will be included as potential mediators of intervention effect. Primary outcomes are anxiety, depression and cancer-specific distress. Secondary outcomes are health-related quality of life (QoL) and benefit finding. Disease variables (e.g. cancer grade, stage) will be assessed through medical records.DiscussionThis study will address a critical but as yet unanswered research question: to identify an effective way to reduce psychological distress; and improve the quality of life for men with advanced prostate cancer.Trial registrationhttp://ACTRN12612000306819

Highlights

Prostate cancer is the most common male cancer in developed countries, and in Australia approximately one-fifth of men with prostate cancer have advanced disease
In this study we propose using the cognitive behavioural approach of MindfulnessBased Cognitive Therapy (MBCT) as relevant to this patient group
mindfulness-based cognitive therapy (MBCT) targets the cognitive processes associated with depression by encouraging participants to disengage from reactive and ruminative states of mind, such as those that are commonly reported by cancer patients [10,11]

Summary

Discussion

The study will provide recommendations about effective psychological interventions to reduce anxiety, depression and cancer-specific distress in men with advanced prostate cancer. The intervention will be able to be utilised in a range of settings including broad reach tele-health support programs; and through support services and support groups internationally. This means that project outputs will be immediately translatable into practice to reduce psychological distress and improve the quality of life of men with advanced prostate cancer. Authors' contributions SKC, DS and MB developed the study concept and aims and initiated the project. All authors contributed to the final manuscript

Background