Originally published as JCO Early Release 10.1200/JCO.2007.16.0036 on April 6 2009

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The Effects of a Presurgical Stress Management Intervention for Men With Prostate Cancer Undergoing Radical Prostatectomy

From the Departments of Behavioral Science and Urology, and the Integrative Medicine Program, The University of Texas M. D. Anderson Cancer Center; and Department of Urology, Baylor College of Medicine, Houston, TX.

Corresponding author: Lorenzo Cohen, PhD, Department of Behavioral Science, Integrative Medicine Program, Unit 1330, The University of Texas M. D. Anderson Cancer Center, PO Box 301439, Houston, TX 77230; e-mail: lcohen{at}mdanderson.org.

Purpose This study assessed the short-term and long-term efficacy of a presurgical stress management intervention at reducing mood disturbance and improving quality of life (QOL) in men undergoing radical prostatectomy (RP) for prostate cancer.

Patients and Methods One hundred fifty-nine men were randomly assigned to a two-session (plus two boosters) presurgical stress management intervention (SM), a two-session (plus two boosters) supportive attention group (SA), or a standard care group (SC). Assessments occurred 1 month before surgery; 1 week before surgery; the morning of surgery; 6 weeks after surgery, and 6 and 12 months after surgery.

Results Results indicated significant group differences in mood disturbance before surgery (P = .02), such that men in the SM group had significantly less mood disturbance than men in the SC group (P = .006), with no significant differences between the SM and SA or SA and SC groups. In the year after surgery, there were significant group differences on Medical Outcomes Study 36-item short form survey (SF-36) physical component summary (PCS) scores (P = .004); men in the SM group had significantly higher PCS scores than men in the SC group (P = .0009), and there were no significant differences between the SM and SA or SA and SC groups. There were no group effects on prostate-specific QOL or SF-36 mental health scores.

Conclusion These findings demonstrate the efficacy of a brief presurgical stress management intervention in improving some short-term and long-term outcomes. If these results are replicated, it may be a useful adjunct to standard care for men with prostate cancer undergoing surgery.

This research was supported by NIMH/NCI Grant No. RO1 MH59432.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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