CHICAGO — Just 2 hours of teaching men with prostate cancer how to self-manage their stress improves their ability to cope with their fears of undergoing radical prostatectomy.
Moreover, the effects of learning how to manage their stress are long-lasting, and could ultimately result in less cost to the health care system, according to a poster presented at the annual meeting of the American Society of Clinical Oncology.
Researchers at the University of Texas M.D. Anderson Cancer Center and Baylor College of Medicine, both in Houston, randomized 150 men with early-stage prostate cancer attending their urology clinics to receive stress management, supportive attention, or usual care.
Stress management consisted of two individual sessions, each 45–60 minutes long, with a clinical psychologist 2 weeks before surgery. During those sessions, the men were taught relaxation techniques including diaphragmatic breathing and guided imagery. They also received coaching on what would happen on the day of surgery and were given coping skills to use after their surgery. In addition, they had one brief, 5–10-minute session on the morning of their surgery, and another brief session 2 days after surgery. The men were also given a stress management guide and an audiotape to help them practice deep breathing and guided imagery at home.
Supportive attention consisted of two individual sessions, each 45–60 minutes long, with a clinical psychologist 2 weeks before surgery, in which the men discussed their fears but were not taught any relaxation skills. They also had two brief sessions—one on the morning of surgery and one 2 days afterward. The third group received standard medical care, and did not meet with a psychologist.
All of the men completed psychosocial and quality-of-life measures at baseline and 6 and 12 months after surgery. Most men were Caucasian (78%), married (85%), and highly educated (80% with some college or higher education).
After controlling for age, ethnicity, marital status, disease stage, baseline prostate-specific antigen, Gleason score, and baseline test scores, the researchers found that men who received either stress management or supportive attention had significantly less distress in the week prior to surgery than did the usual-care group.
On the morning of surgery, those who learned to manage their stress had the least distress, followed by those who got supportive attention. Those who received usual care had the greatest distress. “There was a clear dose-response effect [showing] that a very brief, two-session encounter can really buffer some of the distress and anxiety about going into surgery,” said Dr. Lorenzo Cohen, Ph.D., chief of the integrative medicine section in the department of palliative care and rehabilitation medicine at M.D. Anderson Cancer Center.
“These patients had less interference in their ability to engage in physical functioning, reported less bodily pain and better general health scores as far out as 12 months later. These results strongly suggest that one needs to incorporate some form of stress management [before surgery].”
Patients reported better general health scores as far out as 12 months after the sessions on stress management. DR. COHEN